February 2, 2018
News & Insights

Q: How does the Supplemental Medical Review Contractor determine which reviews to perform? Does SMRC work for CMS or our Medicare Administrative Contractor? 

February 1, 2018
News & Insights

Q: If a patient accidentally puts the paperwork in the trash or on the table, and the information on the paperwork is visible to other patients or family members, is it a HIPAA violation?

January 31, 2018
News & Insights

How can case managers improve teamwork across the continuum of care?

January 29, 2018
News & Insights

Our hospital is located in a rural location where it is difficult to find specialty physicians to provide services to its hospital outpatients. We are trying to determine which of our facilities that furnish services on or near the hospital campus would be excluded from provider-based requirements. 

January 26, 2018
News & Insights

Q: Can you explain when to code pleural effusion as a secondary diagnosis when it is present with congestive heart failure?

January 1, 2018
Briefings on APCs

Our experts answer questions about open-ended queries, how many claims should result in queries, and more. 

December 1, 2017
Briefings on APCs

Our experts answer questions about reporting –X {EPSU} modifiers, retaining written queries, billing inpatient-only procedures, and more. 

December 15, 2017
News & Insights

Q: Our facility does not often use open-ended queries to physicians. Could you give an example of an open-ended query and any disadvantages they may have?  

December 14, 2017
News & Insights

Q: We see many assertions that encryption at the right level meets the National Institute of Standards and Technology (NIST)/HIPAA safe harbor provision with no explanation of what is necessary to prove the breached electronic protected health information (PHI) was actually encrypted at the moment of breach. How can a covered entity prove the PHI was actually encrypted at the time of the breach?

December 8, 2017
News & Insights

Q: Ever since we moved to an electronic health record (EHR), our HIM department has noticed some physicians copying and pasting information from previous records. How do we know when this is allowed or when we can query the provider to clarify?

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