Resolving claims returned with National Correct Coding Initiative edits or Medically Unlikely Edits can be a time-consuming process. Organizations need processes to promote best practices and keep appeals on track, as well as coding and billing policies that address common front-end problems that lead to these edits.
This week's Medicare updates include the Fiscal Year (FY) 2018 Inpatient Prospective Payment System (IPPS) Final Rule; an update to Hospice Payment Rates; Proposed Changes to Comprehensive Care for Joint Replacement Model; and more!
You may find significant changes to E/M reporting in the near future, including a pivot away from two key elements — history and physical exam — that largely determine a given level of service for your most common patient encounters.
Use this sample form to create an inventory of all business associates, including contact information, services provided, the date the business associate agreement is signed, and the date it expires.
Two bundled payment programs could be canceled before they begin, and the scope of a third will be significantly limited if a proposed rule released by CMS August 17 is finalized.
Case managers today have many demands placed on them, from meeting patient needs to ensuring quality, reducing legal risks, and ensuring that care is efficient and cost-effective. In a new HCPro book, Case Management Models: Best Practices for Health Systems and ACOs, Second Edition, author Karen Zander, RN, MS, CMAC, FAAN, tackles numerous topics, focusing on how to structure case management models across the continuum of care.
