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Category: Revenue Cycle Services

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Two Midnight Rule: How to Avoid an OIG Audit

The Two Midnight rule, adopted in October 2013 by the Centers for Medicare and Medicaid Services, states that more highly reimbursed inpatient payment is appropriate if care is expected to last at least two midnights; otherwise, observation stays should be used. Original Two Midnight Rule In general, the original Two Midnight rule stated that, Payable […]

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No Surprises Act: How to Ensure Compliance

In 2021, Center for Medicare & Medicaid Services (CMS) issued the No Surprises Act that went into effect on January 1, 2022. This Act provides Federal protections against surprise billing and limits out-of-network cost sharing under many of the circumstances in which surprise bills arise. Prior to this Act, individuals could be “balance billed” for […]

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Coding Changes are Coming, Ensure Your Organization is Ready

For discharges occurring on and after April 1, 2022, coders will have access to new ICD-10-CM and ICD-10-PCS codes. April 1st will also introduce the new Medicare Code Editor (MCE) edit 20 – Unspecified Code Edit. The 2022 IPPS Final Rule stated there would now be coding updates in both October and April. The goal […]

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2022 Physician Fee Schedule Final Rule: Highlights

Do you know that CMS is making significant changes to split/share and critical care services in 2022? Are your providers aware of the changes? Are they prepared to modify the documentation of these services? Are your coders prepared to report the required modifier? On November 2, 2021, CMS released the 2022 Physician Fee Schedule Final […]

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On-Demand Webinar: COVID-19 Vaccine Mandate in the Workplace

President Biden’s administration recently announced its Path Out of the Pandemic action plan which included specific guidance around a COVID-19 vaccine mandate. The action plan calls for employers with 100 or more employees to require employees to be vaccinated or submit to weekly tests, as well as requiring vaccinations for federal employees, contractors, and hospitals […]

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On-Demand Webinar: Why Documentation in Outpatient Rehabilitation Matters

Staying Ahead of the CMS Auditor: Why Documentation in Outpatient Rehabilitation Matters The Center for Medicare & Medicaid Services (CMS) suspended audits between March and August of 2020 to allow providers to focus on providing care during COVID-19. But now external audits in outpatient rehabilitation are ramping back up. Since the Office of Inspector General […]

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Physician Coding Changes to Address in 2021

This is the year for many changes in healthcare and the physician coding changes that were announced in March 2021 are just one piece of that. Evaluation and Management services (E/M) have not seen a change in more than 25 years; however, this year has significant changes for the office and outpatient locations. These physician […]

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Revenue Improvement Case Study: Outpatient Physical and Occupational Therapy

Blue & Co. reviewed publicly available information on a 120 bed, non-profit, acute-care hospital. The data suggested there was revenue improvement opportunity in their outpatient physical and occupational therapy departments. The department had approximately 27,000 patient visits the previous year. During an assessment, we co-validated a significant set of revenue improvement opportunities: charge capture improvement, […]

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Hospital Outpatient PT/OT/ST Services Can Now Be Provided via Telehealth

On April 30, 2020, CMS issued a second round of sweeping changes to support the healthcare system during the COVID-19 Pandemic. One of these changes is the waiving of limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Prior to this change, only doctors, nurse practitioners, physician assistants, and certain others […]

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Blue & Co., LLC Announces New Partnership With Vsimple | Vsimple and Blue and Co logo

Blue & Co., LLC Announces New Partnership With Vsimple

CARMEL, Ind. (May 5, 2022) – Blue & Co., LLC is excited to announce our new partnership with Vsimple, a workflow management software company based in New Albany, IN.  Blue & Co and Vsimple will be working closely together to address the workflow and process improvement challenges of manufacturers throughout the Midwest. “At Blue & […]

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Proposed Rule FY 2023 for Skilled Nursing Facilities

Proposed Rule FY 2023 for Skilled Nursing Facilities

It is that time of year again! The Center for Medicare and Medicaid Services (CMS) has issued the proposed rule that would update Medicare payment policies and rates for the fiscal year (FY) 2023’s Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The Patient Driven Payment Model (PDPM) was implemented on October 1, 2019. This […]

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Coverage Scheduling Solutions for Physician Practices and Hospital Systems

Scheduling Solutions for Clinician Work-Life Balance

One of the most challenging conversations in any multi-physician practice or specialty-based hospital employed group is about how to create a fair distribution of on-call and/or inpatient hospital service coverage while balancing the duties of an outpatient practice. The COVID-19 pandemic has contributed to clinician burnout, and physicians and Advanced Practice Providers (APPs) place significant […]

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