There are some changes to the Beneficiary and Family Centered Care-Quality Improvement Organization’s (BFCC-QIO) program, and if you’re one of the organizations affected by the changes, you may need to update your patient notices to reflect them.
In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.
Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?
Case managers typically provide support to adult patients in the hospital, focusing on their medical and social needs and easing their transition to the next level of care. But often, these patients aren’t the only ones who need support—they sometimes also have children or grandchildren who are struggling.
CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.
The Revenue Integrity Symposium is filled with so much information that applies to all levels of revenue integrity from those of us in the trenches to management. It will be my third year attending and I’m still finding new sessions to attend. And the networking is amazing!
