Category Archives: Industry Topics

How to Identify Medicaid-Eligible Days for Initial and Amended Cost Reports

In late 2014, a Provider Reimbursement Review Board’s (PRRB) decision highlighted numerous issues supporting the need for hospitals to perform retrospective reviews of initial Medicare Disproportionate Share Hospital (DSH) calculations. The case of Barberton Citizens Hospital v CGS Administrators, LLC/Blue Cross and Blue Shield Association (Barberton) led to a series of changes—including both PRRB actions and Centers for… Read More »

Looking for the Light at the End of the Tunnel: Tactics for Overcoming an A/R Follow-Up Backlog

If there is one thing that revenue cycle management hates to see, it is a growing upward trend in A/R. A buildup can overwhelm even the most experienced of staff and lead to feelings of exasperation and frustration with no clear solution in sight. When hospitals start to see a trend of their A/R increasing, there are a… Read More »

A Substantive Reimbursement Requirement for Medicare DSH Calculations

According to the Centers for Medicare & Medicaid Services’ (CMS) 2016 Outpatient Prospective Payment System (OPPS) Final Rule, for hospitals to potentially qualify for Medicare reimbursement related to any given issue, they must first make a cost report claim for the reimbursement. Alternatively, if the provider feels the reimbursement associated with a specific item doesn’t adhere to current… Read More »

Recent Highlights in Telehealth with Rebecca Mishuris, Chief Medical Information Officer, Boston Medical Center and Kyle Faget, Partner, Foley & Lardner

When the COVID-19 pandemic hit, healthcare providers suddenly shifted from infrequent (if any) use of telehealth, to near universal adoption of the modality. One year in, what have we learned, and what is here to stay? The public health emergency forced providers and regulators to quickly overcome prior barriers that had long impeded adoption of telehealth. While some… Read More »

Q&A with the April 9 Virtual Roundtable Panelist – Donna Schneider

By | March 23, 2021

HFMA Virtual Roundtable – Speaker Q&A – for Donna Schneider, RN, MBA, CPHQ, CPC-P, CHC, CPCO, CHPC, Vice President, Corporate Compliance & Internal Audit, Lifespan, located in Providence, Rhode Island. Tell us about your compliance career journey – I began my career as a graduate of the University of Connecticut (UCONN) starting my clinical journey as a Registered… Read More »