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December 7, 2017
Medicare Insider

This week's note from the instructor examines the process of deciding when to appeal a denial. 

December 11, 2017
Medicare Web

 Can a facility bill a cancelled inpatient-only procedure on Type of Bill 131 or does the patient type/status remain as inpatient with Type of Bill 111?

December 11, 2017

CMS will cut payments for certain services perfromed by off-campus provider based departments (PBD) by 20%, according to the 2018 OPPS final rule. The pay cut will affect PBDs established after November 2, 2015, or which do not meet other exemptions.

December 11, 2017
Briefings on HIPAA

Handling requests for information from law enforcement can throw staff for a loop. Most staff are aware of their organization’s policies and the basic HIPAA requirements for disclosing patient information to family members, friends, and other individuals such as legal guardians. But handling requests from law enforcement officials can be a different matter.

December 8, 2017

Claims denials by commercial and government payers are continuing. A chief reason for this trend is insufficient documentation to support patient status determinations: in other words, why a patient is an inpatient or outpatient. Here’s why documentation is critical to utilization review. 

December 8, 2017
Case Management Monthly
December 8, 2017
Case Management Monthly

The 2018 OPPS final rule, published in the Federal Register on November 13, has two changes that could affect case managers—the removal of the total knee replacement from the inpatient-only list and cuts to payments for drugs purchased through the 340B drug discount program.

December 8, 2017
Medicare Web

Q: Ever since we moved to an electronic health record (EHR), our HIM department has noticed some physicians copying and pasting information from previous records. How do we know when this is allowed or when we can query the provider to clarify?

December 8, 2017
Medicare Web

Intentionally concealing a data breach could lead to jail time for C-suite executives under a bill introduced in the Senate November 30.

December 7, 2017
Medicare Web

Q: I am told if I elect to work from home, I will not be allowed to print any medical records. My home office is secure and I have a shredder. Would printing medical records violate HIPAA, or is this too restrictive?

December 7, 2017
Medicare Insider

This week's note from the instructor examines the process of deciding when to appeal a denial. 

December 6, 2017
Medicare Web

How can we define the role of the nonlicensed case manager extender within our interdisciplinary team?

December 6, 2017
HIM Briefings

OCR’s 2016 guidance on patient access opened up a debate in the industry and brought questions about fulfilling patient access requests to the foreground.