Where Hospice Compliance Meets Revenue Cycle Management

Amidst escalating regulatory scrutiny of hospice expenditure, it becomes imperative for providers to understand the intricate relationship between revenue cycle management (RCM) and compliance. A wave of regulatory actions has recently surged, typified by the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) initiating a national audit of general inpatient hospice services (GIP) due to substantial instances of improper billing practices. Simultaneously, the U.S. Centers for Medicare & Medicaid Services (CMS) intensifies its scrutiny of prolonged stays and elevated care levels, prompting numerous audit initiatives for the recovery of Medicare funds. Zaundra Ellis, Vice President of Hospice Professional Services at Axxess, underscores the external pressures encumbering providers. The increasing focus on hospice billing and claims exacerbates financial challenges, necessitating judicious billing practices and harmonization of claims data amid the escalating costs associated with Medicare hospice services.