Q: Are we required to explain why a vulnerability was not addressed or was deemed low priority in the risk management plan? If so, are there any examples of acceptable ways to document this per OCR?
Revenue cycle leaders can fall into a trap of merely managing problems that pop up. But the danger with a “fix it” approach is that so many of the challenges in revenue cycle are connected.
This week’s Medicare updates include a fact sheet on the transition to new Medicare cards, a table to clarify alternative payment models’ statuses in the Quality Payment Program, a review of a health system’s compliance with inpatient rehabilitation facility service billing requirements, and more!
The implementation of an EHR is a multifaceted, comprehensive project for healthcare organizations. To avoid coding issues during EHR implementation and ensure discharged-not-final-coded is not adversely impacted, dedicated HIM focus and detailed project planning are paramount.
An OIG audit of the University of Michigan Health System revealed noncompliance with four types of inpatient claims, including those associated with billing of DRGs, and two types of outpatient claims, including those billed with modifier –59 (distinct procedural service).
Historically, the social work profession resisted the change from manual documentation to template-based tools, but with the growing emphasis on quality and reducing hospital readmissions, social workers need to utilize case management assessments as a way to communicate risk and pertinent patient details.