With today's emphasis on population health and better management of patients with multiple chronic conditions, payers and providers are increasingly teaming up to improve care. There's good incentive to do so. Patients with multiple chronic conditions are not only common within the Medicare population, but also use a disproportionate share of Medicare dollars.
A new notification requirement is coming next summer. Under the law, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, which was signed by President Barack Obama on August 6, any patient in observation who has been in the hospital for more than 24 hours must be clearly told?verbally and in writing?of his or her outpatient status. Hospital officials have to deliver this notification no more than 36 hours after the patient's outpatient treatments begin.
Provider-based clinics and departments are increasingly common, but the rules for provider-based billing can often be confusing, especially given recent changes to modifiers and place of service codes.
