Three major types of payer record reviews are conducted every year: The Healthcare Effectiveness Data and Information Set (HEDIS), Medicare Risk Adjustment, and Commercial Risk Adjustment. As the volume of payer and health plan reviews continues to climb, millions of patient records are requested.
Coding experts take a look at changes to ICD-10-PCS, including guideline updates, the addition of “other devices” characters, and new tables added for root operation Replacement.
CDI review teams can get bogged down and discouraged by routine. A CDI manager should be visible, positive, and combat team complancency and routine fatigue.
This month's security Q&A answers readers' questions on incidental disclosures, sending protected health information in the mail, and addressing vulnerabilities identified in a risk analysis.
21st Century Oncology, a national network of cancer providers headquartered in Fort Myers, Florida, came under scrutiny by the Department of Justice (DOJ) and the Office for Civil Rights (OCR) earlier this year. In December, the organization agreed to a $26 million settlement with the DOJ and a $2.3 million settlement with OCR. 21st Century Oncology filed for bankruptcy in May.
