An authorization generally applies when an organization wishes to use or disclose a patient’s protected health information for a purpose other than treatment, payment, or healthcare operations, or for legally required purposes. In this case, a patient must sign a HIPAA-compliant authorization form that specifically grants permission to the organization.
Case management directors are held accountable to many metrics. But far too often, information about these metrics is not shared with staff. What a shame. If staff is to work smarter, they must be kept in the know. So, what is the best way to do this? Use the daily departmental huddle to review key metrics on a visual board. The huddle and review of the board should not last more than 15 minutes, but can serve a dual purpose if used correctly. For starters, it ensures staff is up to date with hospital metrics and identifies hot issues for the day. It also alerts case management leadership to case load issues so they can determine where help is needed.
Q: We have received rejections for claims reporting the application of skin substitutes, with the edit stating there is a mismatch of the procedure and the skin substitute. We are using the table that was published in the 2017 OPPS final rule. Has something changed?
Payment reform is here to stay. Although reimbursement will continue to evolve over the next several years, it’s unlikely that payers, commercial or government, are going to abandon risk-based models and value-based purchasing and turn the clock back to fee-for-service and volume over value.
