CMS announced a new voluntary bundled payment model in January called Bundled Payments for Care Improvement Advanced (BPCI Advanced). Bundled payments, like the ones established by BPCI Advanced, are designed to act as a carrot for healthcare organizations by offering them financial incentives to improve patient outcomes, better coordinate patient care, and rein in spending
Q: I work at a marketing company, and we are trying to figure out what exactly we can put on a postcard. What is required, per HIPAA regulations, to be fully compliant if we were to do things like dental patient reminders? We would have patient information from the offices. How would we need to handle that information? What are we allowed to include in our designs?
CMS recently released guidance on submitting claims and filing appeals as it rolls out its new Medicare cards. The new cards will replace the Health Insurance Claim Number, which is based on the beneficiary’s Social Security Number (SSN), with a Medicare Beneficiary Identifier that is not tied to the beneficiary’s SSN.
This week’s Medicare updates include new skilled nursing facility advance beneficiary notice forms, the 2019 Advanced Notice for Medicare Advantage and Part D plan changes, quarterly HCPCS drug/biological code changes, and more!
Organizations and CDI specialists must have a thorough understanding of how regulations and guidelines impact risk adjustment in the outpatient setting. A misinterpretation can easily lead to inadvertent upcoding—and that can lead to costly audits, settlements, and accusations of fraud.
