Providers setting charges based on an understanding of their costs is not a new concept, says Jugna Shah, MPH, president and founder of Nimitt Consulting. However, providers struggle with this or fail to do it correctly, and then stand to deteriorate their future payment rates since CMS relies on provider data to set payment rates not only for inpatient and outpatient services, but also for laboratory services.
In a time when so much attention is focused on issues such as cyber security and the dangers posed from evolving technology, it's easy to forget the HIPAA basics, such as the need for workforce members not to gossip or chitchat about patients with other staff members or people in the community.
Chasing down information on incomplete records can be overwhelming and a lost cause. What do you do when a medical record is incomplete 30 days after discharge (or 14 in California's case) and thus does not meet regulatory standards? Do you file it away without an answer to an open query or a signature from the practitioner? What if the responsible practitioner retired, expired, or is no longer practicing at your facility? Are you doing everything you can to get most deficiencies completed prior to the patient being discharged?
In January 2013, CMS introduced 42 therapy functional reporting G codes (nonpayable). These G codes are to be reported in conjunction with therapy services (physical, occupational, and speech). CMS also introduced seven complexity/severity modifiers to be used with these G codes.
When two bombs went off eight seconds apart at the finish line of the Boston Marathon, there were many emergency plans in place. "There's an emergency disaster plan in place for both the city and the marathon itself," says Peter Moran, RN, BSN, MSN, CCM, emergency room case manager at Massachusetts General Hospital (MGH) in Boston. In addition, each hospital has its own emergency process in place.
