Mastering hierarchical condition categories (HCC) is key to success under new reimbursement methodologies that rely on risk-adjustment, quality, and value metrics such as the Quality Payment Program (QPP). Organizations need to take a close look at their training and audit programs to ensure that valuable information isn’t being left out of documentation—and negatively impacting HCC scores.
Patient care continues to move from the inpatient setting to outpatient. With this change, the challenge of securing comprehensive documentation that articulates the services rendered and the patient care provided now needs to extend across the care continuum.
Q: Our state child support enforcement agency requested the medical records of one of our pediatric patients. Are we allowed to respond to this request without a subpoena?
Having just witnessed nature wreak havoc with back-to-back hurricanes, I feel it’s important to take a few minutes to remind everyone of the importance of Plan B—the backup plan. Let’s look at some real examples of how HIM professionals can be proactive to prevent chaos when unexpected events occur.
