CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.
In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.
Case managers typically provide support to adult patients in the hospital, focusing on their medical and social needs and easing their transition to the next level of care. But often, these patients aren’t the only ones who need support—they sometimes also have children or grandchildren who are struggling.
There are some changes to the Beneficiary and Family Centered Care-Quality Improvement Organization’s (BFCC-QIO) program, and if you’re one of the organizations affected by the changes, you may need to update your patient notices to reflect them.
CMS recently announced a new category of payment programs: the Primary Cares Initiative. Within a few years, CMS expects 25% of primary care providers to join one of the five voluntary payment models.