Patient care continues to move from the inpatient setting to outpatient. With this change, the challenge of securing comprehensive documentation that articulates the services rendered and the patient care provided now needs to extend across the care continuum.
In July, Utah pain doctor Jahan Imani, MD, and Intermountain Medical Management, P.C., entered into a nearly $400,000 settlement with the OIG to resolve allegations that Imani’s practice submitted false or fraudulent claims due to improper modifier use for payment by improperly using modifier -59 with HCPCS code G0431.
Tom, a 29-year-old, unemployed construction worker living on the East Coast, decides to drive on his own to the West Coast in hopes of finding a job. He avoids rest stops to decrease his total trip time. Halfway through his trip, he gets in a serious auto accident caused by another driver. The accident occurs in a state with mandated auto insurance.
Length of stay (LOS) management requires ongoing attention from the director/manager of case management to stay on budget. Directors who divert their attention, even for a few weeks, might find themselves spending too much. To avoid this situation, consider implementing the six best practices for LOS maintenance.
