FWA Briefs

Find news and solutions for healthcare payers and providers. Recognize and avoid potential fraud, waste, and abuse scenarios. Real-time clinical claim editing are analyzed to maximize provider reimbursements.

Medicare Reference-based Pricing RAND Study

  • John Danza
  • Jun 11, 2024
  • Comments
Keyboard

Using the RAND Corporation's newest study to understand payer questions involving Medicare Reference-based Pricing.

Virtual Benefits Administrator and Context4 Healthcare, Inc. announce real-time Medicare pricing automation

  • John Danza
  • Oct 04, 2017
  • Comments
vbalogo

Available to VBA subscribers today, this solution provides real-time Medicare Prospective Payment System (PPS) pricing during claims processing. Direct PPS pricing ensures compliance with the Centers for Medicare and Medicaid Services (CMS). It eliminates complexity and the need to utilize less accurate substitutes like RBRVS.

RAC Ramp Up for 2017

  • Margaret Klasa DC, APN BC
  • Feb 27, 2017
  • Comments

The five regional Recovery Audit Contractors (RACs) are ramping up their automated and complex reviews starting this month. The Centers for Medicare & Medicaid (CMS) Medicare Fee for Service (FFS) audit program awarded contracts in October 31, 2016 ....

Context 4 Healthcare, Inc. announces the latest addition to the Medicare pricing capability of the DecisionPoint Pricing System – Skilled Nursing Facility

  • John Danza
  • Dec 05, 2016
  • Comments
DecisionPoint Pricing System

Context 4 Healthcare, Inc., a leading provider of healthcare compliance and pricing solutions, announces today the implementation of the Skilled Nursing Facility Medicare Prospective Payment System (PPS) as the latest addition to Context’s DecisionPoint Pricing System™. This latest addition further expands the DecisionPoint Pricing System, the first solution in the healthcare industry to provide automated, real-time access to accurate Medicare fees for pricing healthcare claims duri ...

Context 4 Healthcare, Inc. announces the latest addition to the Medicare pricing capability of the DecisionPoint Pricing System – End Stage Renal Disease

  • John Danza
  • Sep 12, 2016
  • Comments
130158907_75 (3)

Context 4 Healthcare, Inc . , a leading provider of healthcare compliance and pricing solutions, announces today the implementation of the End Stage Renal Disease Medicare Prospective Payment System (PPS) as the latest addition to Context’s DecisionPoint Pricing System™. The DecisionPoint Pricing System is the first solution in the healthcare industry to provide automated, real-time access to accurate Medicare fees for pricing healthcare claims during adjudication. When health plan ...

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