News & Analysis

April 16, 2021
Case Management Monthly

Many case management and finance departments have been busy with appeal activities since CMS resumed its regulatory audits on August 3, 2020. Utilization review (UR) nurses are reporting increasing numbers of commercial denials as the coronavirus (COVID-19) pandemic is resolving.

April 16, 2021
Medicare Web

Q: Is it appropriate to report an E/M code for visit services provided in conjunction with a wound care procedure?

April 15, 2021
Medicare Web

Q: Is it safe to immediately shred charts that have been scanned into the electronic medical record system? Should we keep a paper backup?

April 15, 2021
Medicare Insider

This week's note from the instructor examines the effect of virtual communication on case managers during the COVID-19 public health emergency (PHE).

April 14, 2021
Medicare Web

Q: One of the biggest challenges for case management directors is gaining the physician’s cooperation with documentation as they continue to face high patient volumes. What approaches should be taken to get physicians on the same page as case management directors?

April 14, 2021
Medicare Web

CMS should rescind denials recently issued to certain off-campus provider-based departments (PBD) that applied for the mid-build exception under the 21st Century Cures Act, the AHA said in a March 25 letter to CMS.

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