Document Detail


Prepayment review pilot project recently launched by CMS.
MedLine Citation:
PMID:  22299175     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
The Centers for Medicare and Medicaid Services (CMS) has launched a three-year Medicare prepayment review demonstration project in 11 states. The prepayment reviews focus on high cost procedures with a high error rate. The Recovery Auditors (RAs) will perform the reviews. If the project is successful, CMS is likely to require prepayment reviews for all Medicare claims. Case managers should determine the payer mix and volume for targeted procedures and ensure that the documentation meets medical necessity criteria.
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hospital case management : the monthly update on hospital-based care planning and critical paths     Volume:  20     ISSN:  1087-0652     ISO Abbreviation:  Hosp Case Manag     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9603097     Medline TA:  Hosp Case Manag     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-9     Citation Subset:  H    
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