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The OIG audited 21 specific DRGs—and found heavy error rates with these four

The Office of Inspector General (OIG) released results of three acute care hospital audits with a combined $35M in recommended recoupments. 21 specific DRGs were…

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Lessons from loss: A look from the inside of value-based care with Rose Bernards

Listen to the podcast. Rose Bernards is a believer in value-based care. It’s been a driving force in her career.  But it was put to the test…

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OIG offers clinical scenarios that can illuminate your own audit vulnerabilities

The recent Office of Inspector General (OIG) audits of three acute-care hospitals offer a goldmine of clinical/coding examples that you should be using for pre-emptive…

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Inpatient Audit Storm Clouds

Download the report on our resource page. The Office of Inspector General (OIG) never rests. After taking on Medicare Advantage organizations and aggressive risk adjustment…

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Two reasons why the 2027 OPPS proposed rule hurts your hospital

By Brian Murphy   The 2027 OPPS (outpatient) proposed rule landed just prior to the July 4 holiday weekend. CMS’ timing is conspicuous, presumably to…

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