Q: Our facility does not have a standard appeal letter template to respond to medical necessity denials. Do you have any suggestions for how to respond?
Electronic health records fall short of early promises that they would reduce administrative costs, a recent study found. The cost of completing insurance- and billing-related activities in the EHR can represent more than a quarter of professional reimbursement for an emergency department visit.
Q: Is it necessary for organizations to provide HIPAA training for all workforce members, even those who are not involved in patient care? Does that include cafeteria staff, workers employed through a temp or staffing agency, etc.?
The expected growth in healthcare expenditures from 2017 to 2026 is expected to outpace the growth in gross domestic product (GDP) by 1%, resulting in an increase in the health share of the GDP from 17.9% in 2016 to 19.7% in 2026, according to a CMS report.
By asking difficult questions early in a patient’s care about issues such as housing, food security, and neighborhood crime, case managers can combat common transition-related issues in high-cost or high-need patients.
We are updating our charges in our RHC and we want to make sure we are capturing all of the preventive services that we can perform in our clinic. Along with that, we want to audit the documentation. Where can we find a list of RHC preventive services?
Q: Our facility has attempted to use the -X{EPSU} modifiers on 2017 and 2018 claims but our Fiscal Intermediary Standard System (FISS) did not process the claims. I reverted to using modifier -59 (distinct procedural service). Do you have any knowledge of when these modifiers might go into use?
Even going out of business doesn’t protect an organization from HIPAA requirements. The Office for Civil Rights recently announced it reached a $100,000 settlement with the receiver liquidating the assets of Filefax, Inc., a Northbrook, Illinois, medical records company that shut down during an investigation of HIPAA violations.
