A cardiologist leaves her practice and joins another, after which a former patient of hers comes to the new practice for an appointment: Do you bill the visit as a new or established patient visit? Many practices are puzzled by situations like this, says Terry More..
Hospital care expenses aren’t going anywhere but up, unless you—that is, professionals responsible for hospital performance—rein them in. And the pressure to do so is certainly on. The Centers for Medicare and Medicaid Services (CMS) is grading hospitals on length-of-stay and cost-per-case data, and Medicare’s More..
While all medical specialties run the risk of being audited, podiatry ranks especially high for audit risk. That puts you on your toes (pun intended!) when submitting claims. Payers want to see your confidence on even the trickiest aspects of coding, which for 2019 includes More..
Approximately 105 Americans die by suicide every day, according to the Centers for Disease Control and Prevention (CDC), with close to 6% of these deaths occurring in a hospital setting. Understandably, inpatient suicide is a growing concern for the Centers for Medicare & Medicaid Services More..
Scenario: A patient comes into an orthopedic office for an injury that has persisted for 5 months. Should your claim include an ICD-10 code for an acute or a chronic injury? On the one hand, the problem has been going on for only 5 months; More..
“Cross recovery” may not be a hot compliance focus area for federal and state auditors at the moment—but stricter scrutiny is on the horizon, says healthcare management consultant Duane C. Abbey. And because the cross recovery issue can rear its ugly head in a number More..
Is your hospital taking steps to protect suicidal patients from ligature risks? If not, you will now face an immediate jeopardy deficiency citation. The Conditions of Participation (CoPs) for hospitals includes numerous sections, but the section that’s earning hospitals the most deficiencies is Patient’s Rights More..
Embezzlement is a depressingly common problem for medical offices, with Healthcare Management Systems reporting that three out of four physicians will suffer a significant loss due to theft in their careers—and, further, that the theft is typically fraud perpetrated by a trusted employee. Medical consultant More..
A quick Google search for the term “medical necessity” doesn’t turn up anything you don’t already know. In fact, most sites give some version of this definition: “health care services that a physician, exercising prudent clinical judgment, would provide to a patient.” The definition’s vagueness More..
The medical community has embraced the use of portable devices in health care settings—smartphones, tables, and laptops—both for personal and business uses. This convenience, however, comes with a major caveat—by using portable tech, staff may be violating the Health Insurance Portability and Accountability Act (HIPAA). More..