In November 2014, CMS put its certification requirement under the 2-midnight rule to bed, finally conceding that the rule was creating more problems than it solved. While many frustrated case managers celebrated this development, they still aren't completely off the hook. CMS replaced the global certification requirement with two more-specific certification requirements that went into place on January 1, and case managers need to be aware of them.
Q: You are reviewing a computer-generated insurance claim before it is sent to the insurance carrier, and you happen to notice the patient's name on the claim?it's an old friend of yours. You quickly read the code for the diagnosis. Is this a breach of confidentiality?
Mergers and acquisitions in the healthcare industry are often decided upon and negotiated by C-suite staff with involvement from security and IT professionals. However, significant security implications must be considered by both parties prior to, during, and after a merger or acquisition. Security officers are often best suited to dig deep into the information security standards of a facility to identify risks and develop a plan for streamlining security programs between the acquirer and the organization being acquired.
Conducting pre-billing audits can be challenging, but when done correctly, it can save organizations from spending time recoding and rebilling claims that payers deny. These audits can be conducted on the front end, in both inpatient and outpatient settings, once records have been coded.
Despite Bitglass, Inc.'s newness to the healthcare market, the company offers a mobile device management (MDM) solution that is simpler and far less invasive than most solutions available today?something of a feat, as securing data on mobile devices is usually not an easy task.
