This week's note from the instructor looks at the timing of the prior authorization program implementation in light of the current COVID-19 public health emergency.
Coders can raise the flag for the risk management department by signaling unexpected patient care occurrences, such as a nicked organ during surgery. Use this sample occurrence report form as a template for your organization.
This week’s Medicare updates include recommendations on re-opening facilities for non-emergent, non-COVID-19 care, new guidelines for nursing homes on notification of confirmed or suspected COVID-19 cases, a notice about the Accelerated and Advance Payment Programs, and more!
HHS’ Health Resources & Services Administration (HRSA) launched a portal that allows organizations to submit claims for treating uninsured novel coronavirus (COVID-19) patients. Reimbursement is available for claims for testing, treatment, and inpatient admissions billed on or after February 4.
Q: The use of telemedicine and telehealth has expanded dramatically during the COVID-19 pandemic. What should case managers be aware of when determining the most viable telemedicine options for patients?
Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
