What drives specific elements of revenue cycle management with respect to discharge planning in hospitals? Discharge planners’ role in improving the revenue cycle is more proactive than reactive. This means that what discharge planners do during a patient’s hospital stay and how they document it will help the patient accounts department submit a claim likely to be paid without being audited.
This week’s Medicare updates include an OIG report regarding hospital noncompliance with Medicare Requirements for billing outpatient right heart catheterizations with heart biopsies; a new educational initiative to raise awareness of chronic care management; quarterly updates to the ESRD PRICER; and more!
Breaches are expensive and the price tag increases when preparation and formal documentation are lacking. One of the challenges of tracking security incidents and determining if a breach of PHI or PII is a reportable breach is developing a consistent assessment process and building a centralized breach tracking system.
The following is a question and answer form created by Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at R1 Physician Advisory Services in Chicago, to help outline some basics regarding the complex rules surrounding the three-day qualifying stay required, which Medicare requires in order for patients to qualify for the skilled nursing facility (SNF) benefit.You can use this as a starting point to create your own physician and provider training materials on this topic. Ensuring that providers are well-trained on this topic can help ensure patients get accurate information, which can make these discussions less difficult.
Q: We have received some denials of services due to “illegible” or missing authentications and documentation. We still have some handwritten documentation that gets scanned into our electronic health record. Sometimes the physician’s office staff has highlighted where they want the physician to sign, but when we scan it, it is obliterated in the scan.
