Most covered entities still use mailings to communicate with patients and members, so it is worth revisiting Aetna's 2017 mailing breach and the surrounding litigation to understand where negligence occurred and to take away some valuable lessons learned.
It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
Developing an outpatient CDI program isn't just about metrics--departments needs to consider how to engage providers and interact with other teams to be truly effective.
A case manager works on a postacute transfer plan for a patient who is critically ill with sepsis and at risk for acute renal failure. Because the patient has a history of IV drug use, it is likely that long-term acute care hospitals will deny him admission.
UMass Memorial Medical Group Inc. and UMass Memorial Medical Center Inc. reached a $230,000 settlement with the state of Massachusetts in response to two data breaches that exposed the personal health information of more than 15,000 Massachusetts residents.
