This week's note from the instructor looks at the timing of the prior authorization program implementation in light of the current COVID-19 public health emergency.
This week’s Medicare updates include recommendations on re-opening facilities for non-emergent, non-COVID-19 care, new guidelines for nursing homes on notification of confirmed or suspected COVID-19 cases, a notice about the Accelerated and Advance Payment Programs, and more!
HHS’ Health Resources & Services Administration (HRSA) launched a portal that allows organizations to submit claims for treating uninsured novel coronavirus (COVID-19) patients. Reimbursement is available for claims for testing, treatment, and inpatient admissions billed on or after February 4.
Coders can raise the flag for the risk management department by signaling unexpected patient care occurrences, such as a nicked organ during surgery. Use this sample occurrence report form as a template for your organization.
Q: The use of telemedicine and telehealth has expanded dramatically during the COVID-19 pandemic. What should case managers be aware of when determining the most viable telemedicine options for patients?
Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
