Monitor Mondays

Using artificial intelligence (AI), along with an uncanny ability to misinterpret rules, Medicare auditors – specifically, third-party auditors of Medicare Advantage (MA) plans – are ever-ready to pounce on healthcare providers. And too often, it’s like shooting fish in a barrel.The recent posting of three final rules will give auditors ample opportunity to search for more inadvertent errors on Medicare claims. Last week, as reported by RACmonitor, the Centers for Medicare & Medicaid Services (CMS) posted final rules on the same day for the Medicare Physician Fee Schedule (MPFS), the Outpatient Prospective Payment System (OPPS), and the Home Health Prospective Payment System (HHPPS).More rules = more audits.It’ll be the area of focus during the next edition of Monitor Mondays, which will also have the latest national audit news updates from well-respected broadcast consultants, including:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return with another installment of his popular segment