March 6, 2018
News & Insights

Mr. A suffered a cerebrovascular accident, which has affected his ability to comprehend and communicate. Mr. A needs someone to consent for percutaneous endoscopic gastrostomy placement, but he lacks the capacity for decision-making, as certified by two physicians.

March 7, 2018
News & Insights

Does case management need to be a seven-day-a-week service, or can the service succeed with coverage five days per week? As a case manager, I need to retain staff but also provide some consistency to the patients.

March 5, 2018
News & Insights

What requirements must a facility meet to be considered a rural health clinic?

February 28, 2018
News & Insights

An audit of Medicare Part B payments from 2014 through 2016 revealed that CMS improperly paid providers more than $66.3 million for specimen validity tests billed in combination with urine drug tests, according to a report by the OIG.

February 27, 2018
News & Insights

CMS’ Chronic Care Management service is aimed at strengthening access to chronic care management services in primary care settings while reducing costs, and a report on the program prepared by Mathematica Policy Research for CMS indicates its doing just that. 

February 26, 2018
News & Insights

How should rural health clinics bill for an EKG performed at the time of an initial preventive physical exam?

February 28, 2018
News & Insights

How can a facility make a case for bringing on additional case managers and social workers?

February 23, 2018
News & Insights

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?

February 23, 2018
News & Insights

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.

February 22, 2018
News & Insights

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.?

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