CMS is increasingly scrutinizing provider-based regulatory compliance. CMS actively seeks to remove excepted (“grandfathered”) status from off-campus sites that fail to adhere to regulatory expectations. CMS regularly audits enrollment records that may result in payment holds or denials. Provider-Based sites must be en garde.
Recent CMS provider-based reviews typically stem from various triggering events. Most often, CMS review result from:
- Patient complaints;
- Billing/coding audits;
- Medicare 855A enrollment record reviews;
- Revalidation surveys; and
- The Joint Commission findings.
In short, provider-based compliance is now more important than ever.
As a tool to assist hospitals in provider-based monitoring, Advis has prepared its “Provider-based FAQs: 10 Key Questions for Organizations to Ask.” The information in these FAQs stems from the regulatory requirements and The Advis Group’s extensive experience with successfully demonstrating compliance to CMS.
Get Your Provider-Based FAQs Here!