The majority of breached patient records in January were due to hacking and insider-related incidents, according to a report by Protenus, which analyzed the 37 health data breaches reported to the Office for Civil Rights (OCR) in January. The hacking incident which had the biggest impact occurred at Oklahoma State University Center for Health Sciences, where an unauthorized third party gained access to the computer network, and thus access to Medicaid patient billing information.
Q: Are outpatient departments considered part of the therapy cap for hospital-owned facilities? If so, do we need to bill with modifier –KX (Type of Bill 012X)?
This week's note focuses on the Patients Over Paperwork initiative and the changes it created in the process for issuing the skilled nursing facility Advance Beneficiary Notice of Non-Coverage form.
Incorrect inpatient rehabilitation facility (IRF) claims led to $444,458 in overpayments at Memorial University Medical Center, a Savannah, Georgia-based hospital, according to a recent Office of Inspector General audit report. IRF billing compliance has been on the OIG’s radar for several years, and Medicare Administrative Contractors and supplemental medical review contractors have been placing these claims under increased scrutiny.
Inpatient rehabilitation facilities are a valuable postacute option for patients with complex medical and rehabilitative needs. But if you’re planning on referring a patient to one of these facilities, it’s becoming more important to make sure he or she meets medical criteria for the placement before making a recommendation.
