Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?
A Senate bill aims to create regulations that would fill in gaps left by HIPAA to protect consumers’ private health data collected by health tracking devices, apps, and DNA testing kits.
Most proposed solutions to surprise medical bills will negatively affect provider organizations, according to a Moody’s Investors Report released June 20. However, even in the absence of a solution, the growing awareness of the scope and impact of surprise medical bills will harm providers’ relationships with patients.
The current interprofessional climate in healthcare begs for collaborative approaches to identify and address a fresh generation of meaningful outcome measures. Given case managers’ wide lens of the client care process, they are in a prime position to lead this effort.
The Revenue Integrity Symposium is filled with so much information that applies to all levels of revenue integrity from those of us in the trenches to management. It will be my third year attending and I’m still finding new sessions to attend. And the networking is amazing!
The CDC has posted the FY2020 ICD-CM final code changes, and there were no changes to the proposed list of 273 new, 30 revised and 21 invalidated codes that were released in the proposed inpatient hospital prospective payment system rule, April 23.
Q: My team is asking me if we should combine pre-admission testing (PAT) visits with the surgery bill. I'm thinking no because some of the PAT services are not routine for the surgery. However, isn't there a rule about services that can't be billed separately prior to surgery?
Q: A clinician documented "combination Type 1 and Type 2, diabetes mellitus in poor control." This condition is sometimes called Type 1.5 diabetes. What is the correct ICD-10-CM code assignment for Type 1.5 diabetes?
The Revenue Integrity Symposium is the only conference I have seen that is packed with sessions that will give revenue integrity professionals practical information that they can take back and institute the next day to help their facility success financially.
