Reimbursement for provider-based departments (PBD) can be complex, and regulations affecting it have changed frequently over the past year. Section 603 of the Bipartisan Budget Act of 2015, the 2017 outpatient prospective payment system (OPPS) final rule, and the 21st Century Cures Act changed the payment methodology and made multiple adjustments to the definition of excepted (on-campus or grandfathered off-campus) and non-excepted (off-campus) PBDs. Hospitals must know the regulations inside and out and understand how they apply to their PBDs and to avoid denials or noncompliance.
Regulatory compliance reforms have forced CMS to set the bar high for meeting evaluation and management (E/M) standards. This is especially true for clinical documentation improvement (CDI) performance for coding and billing level four and five patient visits in outpatient settings.
Overcoming barriers to care for LGBT individuals can require a culture shift at an organization, but it can be as simple as adding additional options to forms. It’s up to organizations to close the gap, and HIM plays a central role in identifying barriers, implementing change, and fostering a culturally competent environment.
Effective July 2016, as part of The Joint Commission’s Project REFRESH, the Medical Record Statistics form was retired for hospital accreditation surveys. Is it still important to monitor our medical records for presence, timeliness, legibility (paper or printed), accuracy, authentication, and completeness?
