Release of information (ROI) is typically a function that is managed by the HIM department, but privacy and security officers often play a critical role in ensuring records remain secure during transmission.
Hardly a week goes by in the healthcare field without another announcement of a regulatory change, delay, or new initiative. Technology innovation seems to outpace our ability to absorb change or install the latest update on various systems and software applications.
Many of the facilities that once specialized in mental health services across the country have shut their doors in recent years, making it more likely than ever that hospitals will encounter patients with mental health needs in the emergency department (ED).
Historically, the healthcare revenue cycle has been dominated by fee-for-service (FFS) payment arrangements that reimburse providers for the volume of care they provide. These reimbursement models have always been tempered by medical necessity determinations to ensure that the care delivered to patients is in fact medically necessary. Over the past several decades, healthcare costs have been rising precipitously. In response, new payment models have been developed to curb that trend and to deliver more cost-effective care with higher quality and better outcomes.
This January, CMS expanded its readmissions prevention program, adding two more procedures to its list of conditions for which hospitals can be penalized if patients with the conditions are readmitted to the hospital within 30 days of discharge. To prevent these readmissions, hospitals and case managers need to understand the factors that drive them.
