Remittance processing and appeals are integral parts of the revenue cycle. When facilities submit a claim to Medicare, the hope is that the claim will be paid in full and in a timely manner, but that does not always happen.
Q: Case managers used to evaluate their work in terms of tasks completed or length of stay (LOS). Now that LOS has more than a financial meaning, what are some meaningful outcomes case managers can use to set goals for their work?
This week’s Medicare updates include an advance notice of proposed rulemaking regarding changes to Part B drug pricing, an OIG review of billing for inpatient services, the release of skilled nursing facility quality reporting data, and more!
Competing perspectives and priorities can lead CDI programs down the wrong path. Understand how differences in professional backgrounds and approaches to documentation can cause conflict in CDI.
The emergency department (ED) should be considered a patient unit, and the case manager and social worker should triage throughout the day. They must work to improve patient flow in the ED and provide better quality of care for the patient.
