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Thought Leadership

When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.

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Uncompensated Care S-10 Audits are Coming

Uncompensated Care S-10 Audits are Coming

CMS continues to refine the uncompensated care calculation.  Three factors are utilized to calculate uncompensated care reimbursement for IPPS hospitals.  Factor 3 is developed by compiling the cost of uncompensated care that is reported on the Medicare cost report Worksheet S-10.  Effective with federal fiscal year 2020, worksheet S-10 will fully utilize uncompensated care data […]

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Medicare Annual Wellness Visits Overcoming the Roadblocks to Success

Medicare Annual Wellness Visits: Overcoming the Roadblocks to Success

Medicare developed the Annual Wellness Visit (AWV) benefit to provide coverage in order to ensure that beneficiaries receive the most appropriate care by the most appropriate provider at the most appropriate time. This is accomplished by coordinating patient care through one central provider – usually a primary care provider (PCP). The process works by having […]

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Hospital 340B Recertification Reminder

2018 Hospital 340B Recertification Reminder

The Health Resources and Services Administration has set the annual recertification of eligibility for 340B drug discounts for hospitals to begin August 15, 2018, and ends September 12, 2018. Mandatory Requirement Hospitals must complete their recertification through the Office of Pharmacy Affairs Information System (OPAIS). The Authorizing Official and Primary Contact must create their own […]

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Low Volume Payment Update

Low-Volume Payment Update

The Centers for Medicare and Medicaid Services (CMS) recently published the Final 2019 Inpatient Prospective Payment System (IPPS) Rule that modified the definition of a low-volume hospital. While the mileage requirement remained the same, the rule changed the discharge requirement from Medicare discharges to total discharges for Federal Fiscal Years 2019 through 2022. The updated […]

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2019 Hospital OPPS Proposed Rule

2019 Hospital OPPS Proposed Rule

On July 25, the CMS released proposed changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for 2019. Key proposals include: Increasing the OPPS payment rates by a factor of 1.25% and to increase ASC rates by 2.0%. Applying a Physician Fee Schedule-equivalent payment rate for clinic […]

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Kentucky Nursing Home Operators Challenge with Lawsuits is Ongoing

Kentucky Nursing Home Operators’ Challenge With Lawsuits Is Ongoing

Significant dollar amounts have been recently awarded to those who have filed lawsuits against providers.  Kentucky does not have a limit (cap) for the dollar amount for damages that one can recover if injured. A cap placed upon the amount of damages one can recover if injured would help to reduce some of the recent […]

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Documentation, coding, and billing for nursing home services

Documentation, Coding And Billing Requirements For Nursing Home Services

According to the most recent Centers for Disease Control statistics, 1.4 million Americans reside in nursing homes. Federal and state laws require that nursing home residents be under the care of a physician and that those physicians routinely evaluate, manage and direct the patient’s care. The Social Security Act strictly prohibits coverage for routine care. […]

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CMS re-releases timetable for FFY 2020

CMS Re-releases Timetable For FFY 2020 Wage Index Survey And The Preliminary Wage Index PUF

On June 8, 2018, the Centers for Medicare and Medicaid Services (CMS) re-released the timetable for Federal Fiscal Year (FFY) 2020 Wage Index Survey and the preliminary Wage Index Public Use File (PUF). This wage index cycle is based on the Medicare cost reports beginning in FFY 2016 (cost reports beginning between 10/01/2015 and 9/30/2016). […]

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Physician Margin Recovery Improve Performance

Physician Margin Recovery Six Ways To Improve Performance

Many hospitals and health systems are looking for ways to create a sustainable financial model when it comes to their employed physicians.  In this brief article, we will review our thoughts on Physician Margin Recovery and provide six ways to improve performance.  The options presented focus on leveraging your greatest asset: the physician medical group. […]

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How to identify missed opportunities

How To Identify Missed Opportunities

To give patients the best service possible, many physicians end up performing multiple services in one visit. This is great for the patient, but can lead to lost dollars and be tricky when it comes to billing and documentation. Think about when a patient comes in for a follow-up on a chronic problem and decide […]

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Looking forward: Blockchain and Healthcare

Looking Forward: Blockchain And Healthcare

Blockchain is beginning to garner more and more attention in the business media and being touted as the next transformative use of technology across many industries, including healthcare. The most common use of blockchain today is for a variety of cryptocurrencies in circulation around the world, including Bitcoin. However, several industries have begun to look […]

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Update from the AHIMA Advocacy Summit 2018

Update From The AHIMA Advocacy Summit 2018

The American Health Information Management Association (AHIMA) held its annual Advocacy Summit in Washington, DC on March 19-20, 2018. Members from all over the country came together to inspire leadership and influence change. Historically, this event has been an opportunity to advocate for HIM professional interests, build name recognition for AHIMA and the profession, and […]

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MIPS Reporting Deadlines Are Almost Here!

Don’t wait until the last minute to submit your data for the 2017 Merit-Based Incentive Payment System (MIPS) performance period. Now is the time to act. The key dates are: Passed: March 1, 2018, for your 2017 data for your performance category via claims March 16, 2018, (by 8PM EST), for group reporting via the […]

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Skilled Nursing And Post-Acute Providers Have A Proposed New Payment System

The newly proposed Department of Health and Human Services (HHS) budget was recently announced for skilled and post-acute nursing providers. According to major trade groups, the changes for skilled nursing providers are not seen as positive. Payments for post-acute care providers would be changed, establishing a unified payment system based on the needs of patients, […]

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CMS Posts Draft Version Of The MDS 3.0 Data Specifications For Oct. 1, 2018

The Centers for Medicare and Medicaid Services posted a new version of the Minimum Data Set (MDS) 3.0 Data Specifications on January 25, 2018. The DRAFT version proposes significant changes to the MDS Sections: GG – Functional Abilities and Goals; I – Active Diagnosis; J – Health Conditions; and M – Skin Conditions Blue & […]

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Webinars

Changes to Medicare Bad Debt and S-10 Template Effective this Month

The new Medicare Bad Debt template (Exhibit 2A) and S-10 template (Exhibit 3B and 3C) have been finalized by Medicare and are now required for cost reporting periods ending on or after September 30, 2023. This deadline is quickly approaching, and Blue & Co. wants to be sure you are prepared. If you are feeling […]

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Jeff Moffatt received the fellowship designation from the Healthcare Financial Management Association (HFMA)| FHFMA | Jeff Moffatt, FHFMA, CPA/ABV/CITP, ASA, CVA, FACHE headshot

Jeff Moffatt Receives Fellowship Designation from the Healthcare Financial Management Association

CARMEL, Ind. (July 25, 2023) – Blue & Co., LLC is proud to announce that Jeff Moffatt, CPA/ABV/CITP, ASA, CVA, FACHE, recently received the fellowship designation from the Healthcare Financial Management Association (HFMA). “I am extremely honored to be recognized as a fellow of the HFMA,” said Moffatt, a senior manager at Blue. “I would […]

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Proposed Hospital 340B Outpatient Prospective Payment System (OPPS) Solution

On Friday July 7th, 2023, CMS released a proposed rule outlining a plan to correct and reverse the 340B payment cuts from calendar years (CY) 2018 through 2022. This proposed rule is in response to last years Supreme Court ruling that CMS lacked authority to reduce reimbursement for drugs to average sale price (ASP) minus […]

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Annual Wellness Visits: Understanding the Value They Bring

Performing Annual Wellness Visits (AWV) provide a unique value that benefit your healthcare organization, providers and more importantly, your patients. AWVs aligns with population health management, and can identify any needs for additional patient services, including labs, imaging, procedures, and follow-up visits. Benefits of AWVs Annual Wellness Visits also improve quality impact and acuity scores, […]

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What are Annual Wellness Visits?

Beginning 2011, Medicare began covering the Annual Wellness Visit (AWV) as a yearly appointment with a primary care provider (PCP) to create or update a personalized prevention plan at no cost to the beneficiary. This plan may help prevent illness based on current health and risk factors. It is not a routine physical, and an […]

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How to Manage Clinical Validation Denials

In the past several years, hospitals have continued to feel the impact on revenue from Clinical Validation Denials (CVD). The need for a robust CDI team to capture support for clinical indicators while the patient is still in house is more imperative than ever. The other overwhelming piece for revenue cycle teams to manage is […]

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