Prevalence of Parkinson’s disease in the Medicare population during the study year, 2019, is defined as the number of Medicare beneficiaries continuously enrolled in the same calendar year with one or more Medicare claims with a primary or secondary diagnosis of PD. Parkinson’s disease was ident...
Allentown, Pa.-Based Nursing Home Chain Settles Medicare-Claims Charge.Adams, Bonnie
3 From a report prepared for UnitedHealthcare by Human8, “Substantiation of Advertising Claims concerning AARP Medicare Supplement Insurance Plans,” June 2023, www.uhcmedsupstats.com or call 1-877-629-1893 to request a copy of the full report. 4 Member recommendations based on Human8, May...
24 For each ED visit, we included all imaging claims with an ED place of service occurring on the day of the evaluation and management claim. In addition, because an ED visit might span midnight, we included the patient’s imaging the day before and day after the evaluation and management...
And in 2022, the AMA joined aclass-action lawsuitagainst Cigna that claimed the insurer underpaid for claims filed by providers in the MultiPlan network. Related Justice Department 'upping its game' on healthcare antitrust enforcement with new task force ...
Prevalence, Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of Medicare and/or VA Diagnosis Claims Alone or in Combination With a Single eGFR Measurement <15 ml/min/1.73m2, for Identifying Patients With a Sustained eGFR<15 ml/min/1.73m2 eTable 2....
Medicare administrative claims data have been shown to be both accurate and valid48 and are commonly used in studies of spending, enabling comparison to other chronic diseases. Medicare data obtained for research purposes has been subject to a strict quality assurance process. Nevertheless, ...
A recent audit of 1997 Medicare FFS claims by HHS's Office of Inspector General found something rather odd. HCFA has been paying millions of dollars annually for health care services delivered to deceased beneficiaries those whose date of death preceded the start date of the service. Oops....
Often overlooked in performance evaluations of the various contractors employed by the Medicare program to ensure program integrity, is the cost incurred by providers in responding to contractor requests for information related to billed claims and provider costs in appealing improper contractor denials. ...
Documentation of Social, Environmental, and Behavioral Determinants of Health in Administrative Claims Data in US Medicare and Commercially Insured Populationsdoi:10.1681/ASN.20223311S1248cYun HanUniversity of Michigan, Ann Arbor, MIDiane Steffick