Ask the Expert

How can case managers identify high-risk patients in a population health model? 

Within a population health model, which patient populations should case managers focus on with regard to care transitions?

How would a rural health clinic bill for services it provided beyond its scope?

What are the exceptions to the per visit payment limit for a provider-based rural health clinic?

Q: I've seen references to CERT reports regarding potential areas of Medicare coding risk. What exactly is CERT? 

How can rural health clinics bill for services provided before or after posted hours?

Q: Is it a HIPAA concern if a patient and/or visitor takes photos or videos in which other patients, intentionally or not, appear? Are we required to forbid or prevent patients and visitors from taking photos or filming? If so, where is this requirement specified?

Q: Providers at our facility believe the coding and clinical documentation improvement departments send too many queries. What's an appropriate percentage for us to be sending?

Q: Why is there no ICD-10-CM code for hyperosmolarity with Type 1 diabetes when there is a code for hyperosmolarity with Type 2 diabetes?

What resources can case managers use to improve transitions of care?