Versalus Health Blog

1135 Waivers: When do they expire?

In response to the COVID-19 pandemic, CMS issued several blanket waivers to allow hospitals flexibility in responding to the challenges presented by the pandemic. These waivers included...

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Medicare Update: Prior Authorization Request Process for Certain Hospital Outpatient Services

In the Calendar Year 2020 Outpatient Prospective Payment/Ambulatory Surgical Center Final Rule, the Centers for Medicare & Medicaid Services (CMS) introduced prior authorization requirements for...

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COVID-19: Additional $25 Billion CARES Act Fund Allocation & CMS Re-opening Guidelines

HHS announces additional distributions from the CARES Act Provider Relief and CMS issues recommendations for re-opening facilities to provide non-emergent, non-COVID-19 services.

By Joseph...

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COVID-19: Additional $20 Billion CARES Act Fund Allocation

CARES Act Provider Relief Fund guidelines and requirements. Attestation and documentation required by June 3, 2020.

By Joseph Zebrowitz, MD

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COVID-19 CARES Act: Provider Relief Fund Allocation

Latest announcements regarding CARES Act Provider Relief Fund including guidelines on how the Fund dollars will be distributed.

By Joseph Zebrowitz, MD

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COVID-19 CARES Act: Hospitals Must Proceed Carefully

Hospital executives need to consider the amount, timing, and options included in the CARES Act and how these available dollars can best address the multitude of potential financial challenges they...

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Improving Hospital Performance: A Counterintelligence Operation

As payers denial activity increases, hospitals can level the playing field with their payers by following the principles used by the CIA.

By Joseph Zebrowitz, MD

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Chasing KPI’s: How Department Metrics Undermine Hospitals' Medicare Advantage Performance

To evaluate Managed Care contract performance, hospitals should establish a global KPI and focus their efforts on five metrics driving hospital revenue erosion.

By Joseph Zebrowitz, MD

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Medicare Advantage: The New RACs

Medicare Advantage: The New RACs

The Recovery Audit Contractors (RACs) have branched into other areas of audit in hospitals - Medicare Advantage (MA). Since MA plans employ multiple vendors, the...

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Not Hitting Your Revenue Cycle Benchmarks? Look at Utilization Management

It is a truism that hospital financial outcomes result from an interdependent web of departments contributing specific functions and deliverables, commonly referred to as the revenue cycle. Each...

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The Role of the Physician Advisor in the Observation Rate Conversation

The Role of the Physician Advisor in the Observation Rate Conversation

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Medicare Advantage or Disadvantage?

OIG Raises Concerns About Service and Payment Denials Under Medicare Advantage Plans

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