Recently The Joint Commission implemented an initiative, Project REFRESH, to improve processes related to pre-survey, on-site survey, and post-survey activities. Simplification, enhanced relevancy to organizations, increased transparency within the accreditation process, and the utilization of innovative approaches and technology are the goals of Project REFRESH.
The implementation of ICD-10 in 2015 was considered an industrywide success. Coders were trained, HIM departments were prepared, and outsourced coding companies expanded their roles. As we enter the second year of ICD-10, what should HIM directors expect from their coding teams and outsourced vendor partnerships?
HIM and release of information (ROI) professionals shared challenges, triumphs, and insights on their ROI practices in HIM Briefings’ first quarterly benchmarking survey of 2017. We asked about ROI staffing, how respondents’ ROI practices were affected by the Office for Civil Rights’ controversial guidance on patient access fees, and the biggest ROI challenges of 2016.
Each year, CMS reviews procedures on the inpatient-only list, which consists of services typically provided on inpatients and not payable under the OPPS, to consider whether they are being performed safely and consistently in outpatient departments.
CMS made certain concessions from its proposed site-neutral payment policies required by Section 603 of the Bipartisan Budget Act, but it is still moving forward with implementation January 1, 2017, according to the 2017 OPPS final rule.
Most of us are familiar with ICD-10-CM through picking codes from a list in our EHRs or perusing a printed code book. Allow me to suggest that unless we understand the coding rules in the ICD-10-CM Official Guidelines, we may mistakenly pick the wrong code, leading to a potential false claim.
The 30-day all cause acute myocardial infarction (AMI) mortality outcome measure has been linked to hospital payments since the inception of the Hospital Value-Based Purchasing Program (HVBP) in fiscal year 2013. In February 2016, CMS announced that 70% of commercial payers have agreed to use this measure as one of the cardiology outcomes linked to payment.
As HIMB’s 30th year comes to a close, we look back on a year of exciting developments and new challenges. Both HIMB and the HIM profession have seen their share of changes over the past 30 years, and this year was no exception.
Today’s HIM professional needs to understand the various programs and the impact that coding and documentation may have on an organization’s performance. By 2018, 50% of Medicare payments will be tied to value-based alternative payment models.
Most healthcare systems already have a proven process in place to monitor revenue integrity and ensure correct reimbursement. Beyond the day-to-day revenue cycle staff involved in revenue integrity, more than 60% of hospital executives believe revenue integrity is essential to their organization’s financial stability and sustainability, according to a survey by Craneware, Inc.
