CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. Providers are worried that a Recovery Auditor will deny a short inpatient stay for lack of medical necessity and recoup payment years later. So instead, some facilities place patients in observation for longer time periods.
Q. If an organization’s human resources officer is also the plan administrator for the organization’s group health plan (self-insured), does that individual have the right under HIPAA to access records of high-dollar pharmacy/medical claims for the purpose of targeting the insured for wellness programs or other alternative treatment plans?
Chasing down information on incomplete records can be overwhelming and a lost cause. What do you do when a medical record is incomplete 30 days after discharge (or 14 in California’s case) and thus does not meet regulatory standards?
It was a gorgeous afternoon and a perfect day to hold an outdoor summer barbecue for the HIM department at Central Peninsula Hospital in Soldotna, Alaska.
