Northern Arizona Healthcare in Flagstaff uses case management extenders to manage costs associated with its population health program. We thought it was worth a closer look at how these positions work and what these professionals can do within their organization.
Jamie, a novice case manager with only three months of experience, just could not understand the concept of “seamless” as it applied to case management. She had attended her case management orientation with full attention and commitment, but she still couldn’t grasp the concept.
Three major types of payer record reviews are conducted every year: The Healthcare Effectiveness Data and Information Set (HEDIS), Medicare Risk Adjustment, and Commercial Risk Adjustment. As the volume of payer and health plan reviews continues to climb, millions of patient records are requested.
This week’s Medicare updates include a fact sheet on the 2018 EHR Incentive Program payment adjustment; transmittals regarding the January 2018 updates to the OPPS, ambulatory surgery center payment system, and physician fee schedule; a memo detailing three categories of sanctions for proficiency testing referrals; and more!
