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.
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.
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.
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?
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!