Revenue Cycle News and Analysis

January 14, 2021
Medicare Insider

This week's note from the instructor explains how the Most Favored Nation model will affect billing and payment for Part B drugs.

January 15, 2021
Medicare Web

Q: What is an ectopic pregnancy and how would we report this condition in ICD-10-CM?

January 15, 2021
Case Management Monthly

Are your patients skipping needed appointments? A research letter titled Trends in Outpatient Care Delivery and Telemedicine During the COVID-19 Pandemic in the U.S., published in November by JAMA Internal Medicine, hints that this may be the case.

January 14, 2021
Medicare Web

Q: What type of activity must be audited to comply with the HIPAA requirement to audit electronic medical record (EMR) activity? Does this include every action a user takes within a record and the length of time a user spends in a record?

January 14, 2021
Medicare Insider

This week's note from the instructor explains how the Most Favored Nation model will affect billing and payment for Part B drugs.

January 13, 2021
HIM Briefings

Organizations continue to struggle with denials for conditions such as sepsis and pneumonia. Review your processes and then apply these expert tips to help turn the tide.

January 13, 2021
Medicare Insider

This week’s Medicare updates include payment adjustment information from the Consolidated Appropriations Act, revisions to information in the COVID-19 billing FAQ document, a notice of funding opportunity for development of radiology quality measures, and more! 

January 13, 2021
Medicare Web

UnitedHealthcare (UHC) is suspending certain prior authorization requirements for in-network hospitals and skilled nursing facilities through January 31.

January 13, 2021
Medicare Web

Q: Throughout the novel coronavirus (COVID-19) pandemic, case managers have faced many challenges when trying to find placements for patients who need to transfer from the hospital to a lower level of care, such as a skilled nursing facility (SNF). As we enter 2021, what challenges will persist and how can case managers work to overcome them?

January 12, 2021
Medicare Web

President Donald Trump signed H.R. 7898 into law on January 5, amending the Health Information Technology for Economic and Clinical Health Act (HITECH Act) to require the Health and Human Services secretary to consider certain recognized security practices of covered entities (CE) and business associates (BA) when taking enforcement actions.

January 11, 2021
Medicare Web

Q: We're seeing a significant increase in pre-payment audit activity. How can we adapt our audit and denial management processes to cope with this shift?

January 11, 2021
Briefings on HIPAA
January 11, 2021
Briefings on HIPAA

As many anticipated, the Department of Health and Human Services (HHS) has pushed out a flurry of proposed rules in the months leading up to the Trump administration’s departure. Among them is a Notice of Proposed Rulemaking (NPRM) that would make significant changes to the HIPAA Privacy Rule.