March 16, 2018
News & Insights

St. Peter’s Surgery & Endoscopy Center notified patients that their protected health information (PHI) may have been impacted in January during a breach when an unauthorized third-party accessed their servers. Letters notifying patients were mailed out on February 28, reported St. Peter’s Surgery & Endoscopy Center in a statement.

March 14, 2018
News & Insights

What is the best position on the executive team for the director of case management to report to?

March 14, 2018
News & Insights

Changes to HCPCS and CPT® codes, drug and biological payments, and a new separately payable procedure code are coming in April. The transmittal announcing the updates also includes clarification on the application of the modifier –FY payment reduction.

March 15, 2018
News & Insights

Q. We acquired a home health agency and now employ home health nurses, physical therapists, speech therapists, etc. Can we permit workforce members to use their personal cell phones to communicate with patients? Is there a HIPAA-compliant means of doing so for calls, email, and text messages?

March 13, 2018
News & Insights

Case managers in today’s healthcare world face a challenge in confronting growing opioid abuse while also managing the use of opioids in certain circumstances as an effective treatment option for acute and chronic pain.

March 12, 2018
News & Insights

What laboratory services are covered under the rural health clinic benefit?

March 9, 2018
News & Insights

Q: Are outpatient departments considered part of the therapy cap for hospital-owned facilities? If so, do we need to bill with modifier –KX (Type of Bill 012X)?

March 9, 2018
News & Insights

The majority of breached patient records in January were due to hacking and insider-related incidents, according to a report by Protenus, which analyzed the 37 health data breaches reported to the Office for Civil Rights (OCR) in January. The hacking incident which had the biggest impact occurred at Oklahoma State University Center for Health Sciences, where an unauthorized third party gained access to the computer network, and thus access to Medicaid patient billing information. 

March 7, 2018
News & Insights

Incorrect inpatient rehabilitation facility (IRF) claims led to $444,458 in overpayments at Memorial University Medical Center, a Savannah, Georgia-based hospital, according to a recent Office of Inspector General audit report. IRF billing compliance has been on the OIG’s radar for several years, and Medicare Administrative Contractors and supplemental medical review contractors have been placing these claims under increased scrutiny.

March 2, 2018
News & Insights

Q: We are trying to educate our coding department about medical necessity, but has CMS or Medicare defined it anywhere? How can we explain it to staff?

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