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Ensure all outpatient services have a corresponding code and monitor for duplication of services. Allocate resources to the process.(done internal or external, # employees/ hours needed to complete review.Review departmental charge tickets to ensure codes correlate to CDM. Establish the communication mechanism for the team. Conduct interviews and review line item, per department. Finalize changes to the CDM and report to the appropriate department.staff registers patient -getting demographics, insurance and creating account.services are documented by clinicians involved in patient care.Patients without commercial insurance or not covered by a government health care plan should contact the hospital prior to a procedure to discuss charges, alternative pricing, and payment terms.is a master inventory list of all procedures, services, pharmaceuticals, devices, and supplies that can be reported or performed in the hospital.Information transferred to billing dept.claims created and run through claim editing system(scrubber).claims with errors reviewed and corrected. Payer adjudicated the claim (paid or denied or suspended). Today, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to empower patients and advance the White House My Health EData initiative and the CMS Patients Over Paperwork initiative.The final rule issued today makes updates to Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) that will incentivize value-based, quality care at these facilities.

The IPPS/LTCH PPS final rule also updates geographic payment adjustments for IPPS hospitals.“We’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork,” said CMS Administrator Seema Verma.“We’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes.CMS looks forward to continuing to work on geographic payment disparities, particularly for rural hospitals, to the extent permitted under current law and appreciates responses to our request for public input on this issue.By allowing the imputed wage index floor to expire for all-urban states, CMS has begun the process of making geographic payments more equitable for rural hospitals.

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