Measuring the impact of HCCs

March 1, 2017
HIM Briefings

HCCs are the basis for risk adjustments for reimbursement models like Medicare Advantage, accountable care organizations (ACO), and other value-based purchasing measures such as Medicare Spending Per Beneficiary. Poor understanding and application of HCCs mean that a hospital’s patients may be much sicker in reality than they appear to be on paper. And that will hit reimbursement hard.

The OIG recognizes and pursues two seismic issues related to the 2-midnight hospital policy

March 8, 2017
HIM Briefings

In several recent reports, the Office of Inspector General (OIG) determined that providers are, on average, variant from expected volumes on both short stay inpatient and long stay observation cases. What was not made clear in the OIG report is the reason why it believes such variances exist. The answer to this question likely rests within the details of how hospitals have adjusted (or not adjusted) to the use and application of “new criteria” in their daily and ongoing Medicare billing compliance processes.

Are you using offshore vendors for coding, transcription, or other HIM services?

March 15, 2017
HIM Briefings

When it comes to using offshore resources, there are several important compliance requirements HIM professionals need to know. These requirements were created by CMS a decade ago and apply to the use of offshore contractors for all Medicaid, Medicare, and TRICARE patients. 

HIM Briefings' Q&A

March 22, 2017
HIM Briefings

This month's Q&A answers readers' questions about release of information, using whiteboards in patient rooms, and breach response.

Definitions and documentation in the ICU crucial in severity and risk adjustment

March 29, 2017
HIM Briefings

How we define, diagnose, and document diagnoses that predict morbidity and mortality is essential if we want our patient’s risk to be accurately portrayed.