Jerry and Bob are twins who, up until six months ago, lived with their mother. When she died suddenly and her home was foreclosed, the two brothers found themselves homeless. Neither of them has a job, and both are disabled: Jerry has a physical injury caused by a past construction job, and Bob has severe cardiac disease. On the coldest night of the fall season, Bob is stricken with severe chest pain that is unrelieved by oral nitroglycerin.
Q: Our facility does not have a standard appeal letter template to respond to medical necessity denials. Do you have any suggestions for how to respond?
Transitions of care are a time when lapses can occur and problems can arise. Transfers are one of those transitions, and asking the right questions can help ensure problems aren’t overlooked, including ones that could later interfere with quality.
Electronic health records fall short of early promises that they would reduce administrative costs, a recent study found. The cost of completing insurance- and billing-related activities in the EHR can represent more than a quarter of professional reimbursement for an emergency department visit.
Q: Is it necessary for organizations to provide HIPAA training for all workforce members, even those who are not involved in patient care? Does that include cafeteria staff, workers employed through a temp or staffing agency, etc.?
