HCPro, JustCoding Outpatient - 2017 Issue 51 (December)
Healthcare News: Insufficient documentation causes most improper payments for outpatient services, report says
December 19th, 2017
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Article Overview
This news article covers CMS findings from the 2016 Medicare Fee-for-Service Improper Payments Report, with emphasis on hospital outpatient services and the main reasons those claims were found improper. It is relevant to hospital outpatient billing, Medicare compliance, and documentation review professionals who need a high-level understanding of current payment error trends and the types of supporting records discussed in the report.
Why This Topic Matters
Understanding improper payment findings helps outpatient facilities and coding/compliance teams focus their documentation review efforts and reduce claim vulnerability. The article highlights Medicare payment integrity issues that can affect audit readiness and billing accuracy.
What You Will Learn
- What the article reports about Medicare Fee-for-Service improper payment findings for outpatient services
- Which broad outpatient service categories are discussed in the CMS report context
- Why documentation is emphasized as a major compliance issue in outpatient claims
- Where to find the referenced CMS supplementary report materials for additional detail
Who Should Read This
- Hospital outpatient coders
- Medicare billing specialists
- Revenue cycle professionals
- Compliance staff
- Health information management professionals
- Audit and documentation review teams
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