The case manager shortage is a national crisis, affecting care coordination from hospital to community. Patients, families, and children are feeling the impact.
Not all hospital-level care needs to take place in a hospital. Since it was first announced in November 2020, CMS’ Acute Hospital Care at Home waiver program has allowed organizations to provide acute care to qualifying patients in their homes rather than in the traditional setting.
This week’s Medicare updates include a notice about the suspension of prior authorization for certain DMEPOS items, an update on billing for one of the COVID-19 monoclonal antibody treatments, the quarterly update to the clinical laboratory fee schedule, and more!
CMS is weighing an expansion of the hospital outpatient department prior authorization program, changes to 340B reimbursement, and alternative rate setting data among other proposals in the 2023 Outpatient Prospective Payment System (OPPS) proposed rule. Review other major proposals to understand how your organization could be affected.
Revenue erosion and denials are often easily prevented, but simple errors may evade traditional, reactive denials management processes. Apply these tips to reduce and prevent common denials due to medical necessity, the three-day payment window, and more.
