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 22, 2018
News & Insights

Q: How do we know if our facility is performing too many patient tests? What can we do to prove the tests are medically necessary?

June 22, 2018
News & Insights

Around a dozen employees of the Washington Health System (WHS) in Washington County, Pennsylvania, have reportedly been suspended for HIPAA violations involving alleged inappropriate access to patient records, according to the Washington County Observer-Reporter.

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.

Pages