Hospital
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Different CPT done than was authorized? Payers refuse to pay the claim
Some claims denials stem from incorrect CPT codes given by providers.
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More payers asking for peer-to-peers
Patient access needs excellent processes to respond to payer requirements for peer-to-peer review of the patient’s medical records, says Ketan Patel, a senior manager in the healthcare provider segment of strategy and operations for New York City-based Deloitte Consulting
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Payers Want Detailed Clinical Info for Authorizations
You need to know why a procedure is necessary ... right?
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Patient satisfaction surveys seriously flawed, report says
The patient satisfaction surveys used by CMS to assess hospitals are not valid, according to a new report by the Hastings Center, the nonpartisan research center on bioethics.
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Primary care doctors troubled by hospital quality metrics
Half of the nation’s primary care physicians view the increased use of quality-of-care metrics and financial penalties for unnecessary hospitalizations as potentially troubling for patient care, according to a new survey from The Commonwealth Fund and the Kaiser Family Foundation.
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Quality data may be skewed by other hospital readmissions
Readmission rates may not be an accurate measure of hospital quality if the analysis does not factor in the readmissions from other hospitals, researchers suggest in a new study.
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Arkansas doctors, hospitals fight over peer review law
Three Arkansas hospitals are continuing their fight against a 2013 law that governs hospital peer reviews, taking the case to the state supreme court. In part, the law requires that hospitals notify physicians that they are under review and allows them to have a lawyer.
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Videotape review reveals flaws in tech credentialing
A recent study of surgeons credentialed to perform bariatric surgery suggests that current hospital methods for assessing competence in new and complex procedures are inadequate.
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Hospital settles lawsuit after credentialing surgeon on robot
The first lawsuit to be decided involving the da Vinci surgical robot suggests that hospitals are going to be held responsible if they do not properly credential physicians on emerging technology. The company making the device may be in the clear.
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New technology poses credentialing challenge
Patients will suffer the consequences, experts say, and hospital quality leaders will be blamed for not keeping up with the times.