This note from the instructor explores the intricacies of the acute and post-acute transfer policy in light of recent OIG audits on hospital compliance with these policies.
Q: As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual. How will this affect organizations, and what can they do to smooth the transition?
This week’s Medicare updates include coding and payment information for the Johnson & Johnson COVID-19 vaccine, an OIG report on trends toward more expensive inpatient hospital stays, an MLN article on billing for services when Medicare is a secondary payer, and more!
Supporting accurate Hierarchical Condition Category (HCC) capture is essential to success under the growing number of risk-adjusted payment models. With their strong knowledge of coding and documentation guidelines and insight into emerging trends, coders are a key part of that strategy.
In the weeks leading up to his departure from office, former President Donald Trump signed H.R. 7898 into law, amending the HITECH Act to require the Health and Human Services secretary to consider certain recognized security practices of covered entities (CE) and business associates (BA) when taking enforcement actions.
