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?
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?
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?
Q: What are the benefits to having coders review charts for appropriate capture of CCs and MCCs, and how can our coding team get started in this process?
Q: If we end a contract with a business associate (BA), does the BA need to provide us with assurance that all protected health information (PHI) has been destroyed? Is this something that should be written into the initial contract? What are the steps to take if the BA does not respond to requests to confirm deletion of PHI?
Q: The combination of hospitals' financial constraints and the isolation associated with remote work can create low morale within a case managment department. How should case management directors combat these factors?
Prior authorizations will be needed for certain hospital outpatient services starting on July 1, 2020. The change was made in the 2020 outpatient prospective payment system/ambulatory surgical center final rule. Hospitals are required to get prior authorization for the following five procedures:
Q: I am confused on the HIPAA rules for patients needing to show their driver’s license at the doctor’s office, hospital, or any other medical facility so the driver’s license can be scanned and put into their systems. I have refused to do that, but the facilities informed me that they were required by Medicare to scan the driver’s license. Is there a rule that clearly states that this is a requirement?
