The powerful data analytic tools used for predicting patients at risk for high healthcare utilization, healthcare costs, and mortality are essential to a successful population health model of care.
CMS recently released updated guidance on billing intensity-modulated radiation therapy (IMRT) after an OIG audit found a 100% error rate in billing certain IMRT planning services.
Most covered entities still use mailings to communicate with patients and members, so it is worth revisiting Aetna's 2017 mailing breach and the surrounding litigation to understand where negligence occurred and to take away some valuable lessons learned.
Developing an outpatient CDI program isn't just about metrics--departments needs to consider how to engage providers and interact with other teams to be truly effective.
