Q: We have a case in which there was an observation order for a patient with Medicare Part B as a primary insurance and Cigna as a secondary insurance. If this is billed to Medicare and denied, can the secondary insurance be billed?
U.S. District Court Judge Michael H. Simon issued preliminary approval on July 29 of an agreement that would require Premera Blue Cross to pay $74 million to settle a class-action lawsuit resulting from a 2015 data breach.
Q: Suppose a patient comes in for psychological testing evaluation. The provider interprets the test results and patient data, prepares a report, and begins treatment planning. If the interactive feedback session is held several days later, how would this be reported using CPT codes?
This week's note from the instructor checks in on the current status of the 340B court case in light of CMS' request for comments in the 2020 OPPS proposed rule on ways to remedy the 340B reimbursement adjustments.
The field of case management is rapidly evolving as hospital leaders look to case managers to help them meet a host of new regulatory requirements and financial goals. But too often this has put undue pressure on case managers and taken focus off their most important job—coordinating care.