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?
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.
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.
Hospitals, health systems, and long-term care facilities are being challenged by census workers requesting information about patients and residents to conduct an accurate census. Some have gone as far as stating that they have a right to access hospital electronic health records (EHR).
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?
As organizations respond to the COVID-19 pandemic, a growing number are turning to telemedicine to safely meet patient demand. “The current crisis is expanding people’s willingness to shift the paradigm both on the provider and patient side,” says Diane Iverson, RN, BSN, BS, ACM, CCM, a Baltimore-area case manager. “Systems are gearing up to expand services rapidly.”
