News & Analysis

February 6, 2019
News & Insights

Q: Do the Case Management Society of America’s standards of practice still apply when using a population health approach to case management?

February 6, 2019
News & Insights

Federal fraud watchdog agencies may be taking a closer look at Medicare Advantage in 2019, according to a recent report released by Bass, Barry & Sims, a Washington, D.C.-based law firm.

February 5, 2019
News & Insights

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions, and the total cost of limited health literacy to the U.S. healthcare system is estimated at $50–73 billion.

February 4, 2019
News & Insights

Q: What type of claims edit data should we capturing and reviewing as part of denials management?

February 4, 2019
Briefings on HIPAA

In recent months, OCR has expressed concern that providers and other covered entities may be reluctant to inform and involve the loved ones of individuals facing health crises like opioid use disorder for fear of violating HIPAA. Here, we look at some common misconceptions about privacy under HIPAA and point to the information that patients and families need to know.

February 1, 2019
Briefings on APCs

Pay close attention to new CPT documentation and coding guidance for reporting radiological imaging. For example, a new paragraph titled “Imaging Guidance” in both the surgery and medicine guidelines advises that even when imaging guidance or supervision are included in a surgical procedure code, you must still follow the radiology documentation requirements in the CPT manual.

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