January 11, 2021
News & Insights

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?

January 8, 2021
News & Insights

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?

January 7, 2021
News & Insights

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?

January 6, 2021
News & Insights

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?

December 23, 2020
News & Insights

Q: What strategies should case managers employ when guiding patients in end-of-life decisions?

January 4, 2021
News & Insights

Q: Are procedures removed from the inpatient-only (IPO) list in 2021 subject to the 2-midnight rule?

July 21, 2020
Case Management Monthly

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:

December 21, 2020
Briefings on HIPAA

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?

December 21, 2020
News & Insights

Q: What are some key revenue cycle topics that should be included in education geared toward clinical staff?

December 18, 2020
News & Insights

Q: When might it be appropriate to report computer-aided mapping of the cervix uteri using 2021 CPT add-on code 57465 (computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect)?

Pages