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January 18, 2018
Medicare Insider

This week's note examines the intricacies of the BPCI Advanced payment model, a new voluntary bundled payment model set to go live in October. 

January 23, 2018
Medicare Web

The main dilemma for the boardroom and the frontline case management professionals is they do not warm up to “models.” In fact, models are looked at with skepticism, and if they are being evaluated, models are looked at as warnings about more work to come. Looking at the patient/family level of care, every patient and family should receive the following services from case management.

January 22, 2018
Medicare Web

How would a rural health clinic bill for services it provided beyond its scope?

January 22, 2018
Briefings on HIPAA

Everyone is familiar with the words “privacy” and “security,” but what do these terms mean to the experts, and what is the relationship between privacy and security?

January 22, 2018

Insufficient documentation caused most improper payments for voluntary advance care planning (ACP) services submitted during a three-month period in 2016, according to a Comprehensive Error Rate Test (CERT) report in the most recent Medicare Quarterly Provider Compliance Newsletter.

January 19, 2018
Medicare Web

A Greenfield, Indiana-based hospital paid a ransom recently to regain access to its computer system.

January 19, 2018
Case Management Monthly

The 2-midnight rule was designed to simplify decisions on whether to order inpatient or outpatient observation services for patients and to reduce the volume of observation cases. However, some hospitals and healthcare systems have reported that the rule has actually increased confusion around level of care, without lowering observation volumes.

January 19, 2018
Medicare Web

Q: Could you discuss or explain evaluating encounter billing vs. monthly billing for recurring outpatient services such as chemotherapy infusions or radiation oncology?

January 18, 2018
Medicare Insider

This week's note examines the intricacies of the BPCI Advanced payment model, a new voluntary bundled payment model set to go live in October. 

January 18, 2018
Medicare Web

Q: We’re looking into have our coding outsourced to a company based in India. I’m assuming that HIPAA does not apply to a foreign company. What are the potential HIPAA risks for us? If we discover that the outsourced company experienced a breach, would we still be liable? What do we need to be aware of in terms of HIPAA compliance?

January 17, 2018
Medicare Insider

This week’s Medicare updates include the announcement of a new bundled payment model, clarification on CMS’ regulations regarding texting of patient information, notification of the new interest rate for overpayments and underpayments, and more! 

January 17, 2018
HIM Briefings

Given it’s time for New Year’s resolutions—and my resolution is to work smarter, not harder—it seems appropriate to talk about techniques for bringing balance back into our lives.

January 17, 2018
Medicare Web

How can case managers identify high-risk patients in a population health model?