News & Analysis

June 22, 2018
Case Management Monthly

If provisions of the 2019 IPPS proposed rule related to admission orders become a reality in October, case managers could be relieved of a big headache. If this portion of this rule is finalized, CMS would reverse the requirement that a physician’s order must be in the medical record for the hospital to bill for inpatient services under Medicare Part A.

June 21, 2018
News & Insights

Q: Is it a violation of the HIPAA Privacy Rule to make a comment while working at a pharmacy that “we’ve seen a lot of flu cases”?

June 21, 2018
Medicare Insider

This week's note from the instructor reviews the impact recent updates to the National Correct Coding Initative (NCCI) edits and Integrated Outpatient Code Editor (IOCE) will have on billing processes.

June 20, 2018
News & Insights

The Office of Inspector General (OIG) plans to address concerns regarding capitated payment models by putting preauthorization denials under review.

June 20, 2018
HIM Briefings

When evaluating a code edit, it’s necessary to understand exactly when or where in the claim or billing process the edit arose. Look to coding guidance to help edit resolution efforts.

June 20, 2018
News & Insights

How can case managers and social workers assist patients in lowering medication costs?

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