tci ED Coding & Reimbursement Alert - 2015 Issue 10

Kudos to the QIOs

You’ll be getting medical reviews from a new entity for 2016. CMS has proposed to switch from Medicare Administrative Contractors (MACs) to Quality Improvement Organizations (QIOs) to provide the first line medical reviews regarding questioned admissions. QIOs, private contractors charged with monitoring the quality of care provided to Medicare beneficiaries, are a good choice for first line reviews as they (in their various program incarnations), have generated a respectable track record across numerous clinical review issues for more than 30 years, says Michael Granovsky, MD, FACEP, CPC, President of LogixHealth a national ED coding and billing company based...

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