It's a scenario that plays out at hospitals across thecountry each day. A Medicare patient is scheduled for a procedure typically performed on an outpatient basis. But the patient has a number of preexisting health conditions, such as chronic obstructive pulmonary disease or diabetes, which are going to make the surgery and recovery more complicated.
Determining whether a patient should be an inpatient or on observation services can be a challenging call. If the wrong decision is made or the right decision isn't properly documented, the claim will likely be denied.
Sometimes the best care a patient can receive in the ED is to not be treated there at all. They can often have treatment needs and do received meds, but that does not necessarily entail an admission.
September has always been synonymous with students returning to the classroom. While that may not be reason enough to review the HIPAA Privacy Rule, a more compelling reason to dust off the HIPAA education materials might be the government's increase in enforcement efforts.
When evaluating a family's ability, willingness, and availability to provide needed care to patients, discharge planners may become aware of scenarios that are not reasonable or safe for the patient.
The Community-Based Care Transitions Program (CCTP), also known as Grant 3026, is mandated by Section 3026 of the Patient Protection andAffordable Care Act and provides funding to test models for improving care transitions for high-risk Medicare beneficiaries.
