Correct, complete documentation is the foundation of a sound medical record and compliant reimbursement, but getting that foundation in place can be challenging. Clinicians are juggling critical tasks in a high-stress situation, and administrative burden of electronic documentation and the disconnect that results from spending more time looking at a screen than a patient are often cited as the primary factors in physician burnout. Enter the medical scribe.
Medicare billing edits such as National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) must be resolved at their root cause so that they do not continue to occur on claim
Brush up on the Joint Commission's data management session topics before surveyors visit your hospitals. Follow these tips to ensure a successful survey.
Creating and maintaining an ethical work culture is everyone's responsibility. Always set an example of respect, honesty, and fairness for your family, friends, and colleagues.
Amidst the hospital-of-the-future buzz at HIMSS18 was keen interest in resources aimed at helping providers navigate the present-day transition to value-based care. Many healthcare executive and clinician attendees were eager to identify ways healthcare technology can help their organizations transition from fee-for-service to pay-for-performance reimbursement models.
Organizations are generally keeping up due diligence when it comes to HIPAA compliance training and essential auditing, despite an increasingly challenging array of threats directed at them. However, confusion still holds sway on risk analysis and more robust audit functions.
Many hospitals find that their Patient Safety Indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions. That may be because they fail to realize that the Agency for Healthcare Research and Quality has a risk-adjustment methodology that predicts each of these PSIs and is dependent upon the documentation and coding of PSI-sensitive risk factors.
Preventive care is an essential component of rural health clinic services, but Medicare's coverage and billing rules for these services—including annual exams and vaccines—can be complicated to navigate.
In today’s uncertain regulatory environment, establishing an internal audit process is more important than ever to ensure proper billing and reimbursement. Follow these eight steps to establish an efficient internal audit and compliance program.
