Hospital articles

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Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.

Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.

Inpatient hospital short stay reviews

Inpatient hospital short stay patient status reviews for acute care inpatient hospitals, long-term care hospitals, and inpatient psychiatric facilities.

Guidance on hospital inpatient admission decisions

In this special edition article, CMS stresses the importance of staying informed of all CMS national inpatient hospital policy and national and local coverage determinations regarding making a…

Part A outpatient infusion and hydration services

Read this article for important billing information for outpatient infusion and hydration services.

Inpatient admitted prior to entitlement

There are special billing guidelines to follow when the beneficiary becomes entitled to Part A benefits in the middle of an inpatient stay.

Long term care facility prospective payment system standard versus site neutral payment

For discharges on or after October 1, 2015, there are two separate payment categories for long term care hospital (LTCH) patients. This article provides those details.