February 27, 2019
News & Insights

Q: Can you explain the difference between patient capacity and patient competence and explain what role a case manager has in determining them?  

February 27, 2019
News & Insights

Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.

February 26, 2019
News & Insights

The American Hospital Association (AHA) has launched its 2019 Innovation Challenge, which focusses this year on using technology to address the social determinants of health and connect people with resources to address community health needs.

February 25, 2019
News & Insights

Q: Can we correct and resubmit a claim denied before payment as we do claims that are sent back with a pre-payment rejection?

February 22, 2019
News & Insights

The American Hospital Association (AHA) released a letter on February 12 in response to HHS’ request for information on modifying HIPAA rules to improve coordinated care, calling for more training and education as opposed to regulatory changes.

February 22, 2019
News & Insights

Q: What is the difference between ICD-10-CM code I24.8 (other forms of acute ischemic heart disease) and code I21.A1 (myocardial infarction type 2)? In which situation would each of these codes be reported? 

February 21, 2019
News & Insights

Q: Is it a reportable breach if an entity had the ability to send encrypted email, but an unencrypted email was sent to the correct recipient because of a computer fluke or user error?

February 20, 2019
News & Insights

CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.

February 20, 2019
News & Insights

Q: Do you have any tips for developing a hospital case management model that we can use to evaluate effectiveness across all levels of care?

February 19, 2019
News & Insights

A financial assessment may be time-consuming and difficult, as many patients are reluctant to inform the case manager of the financial risks they face, but it is critical to assisting patients meet the most basic of needs.

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