There are many questions out there about what a managed service provider (MSP) should do for covered entities and business associates. There are different flavors of MSPs out there; therefore, it’s important to think about what your MSP will do for you and how to spot an MSP that may not be a good fit for your organization.
Working in case management for years has taught me to use the ABCs in at least two tasks I perform daily. Not only are the ABCs useful in developing patient discharge plans, but they also help in setting my daily caseload priorities. How do they work?
Q: Based on CPT Assistant, CPT code 29874 (knee arthroscopy with removal of loose/foreign body) may be reported with modifier -59 (distinct procedural service) if performed in a separate compartment from procedures 29875-29881. This advice conflicts with NCCI edits between codes 29874 and 29880. Do the NCCI edits override the advice in CPT Assistant?
Reimbursement for provider-based departments (PBD) can be complex, and regulations affecting it have changed frequently over the past year. Section 603 of the Bipartisan Budget Act of 2015, the 2017 outpatient prospective payment system (OPPS) final rule, and the 21st Century Cures Act changed the payment methodology and made multiple adjustments to the definition of excepted (on-campus or grandfathered off-campus) and non-excepted (off-campus) PBDs. Hospitals must know the regulations inside and out and understand how they apply to their PBDs and to avoid denials or noncompliance.
Patients who participate in accountable care organizations (ACO) and care management teams may have fewer hospitalizations and ED visits and lower Medicare spending, according to a recent study in Health Affairs. Care management is a cornerstone of ACO interventions.
This week’s Medicare updates include new CLIA waved tests, changes to the payment policies for Reciprocal Billing Arrangements and Fee-For-Time Compensation Arrangements (formerly “Locum Tenens Arrangements”), implementation of modifier -CG for Type of Bill 72x, and more!
Compiling the statistics for insider threats to patient privacy is easy. It’s the mitigation of these risks that takes time, strategy, and commitment. According to the January 2017 Protenus Breach Barometer, internal health system employees were responsible for 58.4% of breached patient data during January 2017.