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DON’T FORGET THE 2-MIDNIGHT RULE WHEN DIRECTLY ADMITTING A PATIENT FROM YOUR OFFICE…
There is a lot going on in our world today. Let us keep others in our thoughts…… Otherwise, all continues to be quiet on the practice front.  We all are working diligently to continue to provide quality-of-care to our patients and balance the fine line of communicating that care to 3rd party reviewers explicitly & concisely. As 2015 comes to its wonderful, festive finale there are many (at times overwhelming) details to our practices of medicine that we must keep...
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23

Well, everyone we've survived October 1, 2015 !!!

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Well, everyone we've survived October 1, 2015 !!!
Some have equated October 1st, as being similar to Y2K - the non-occurrence...and I must admit the Earth did not get swallowed up and disappear from the universe. We are all still here. It has been a quiet transition, and I'm so happy for that. The stressors within healthcare were truly palpable - especially regarding physician documentation and coding.   Hooray for us. We survived.   We must continue to strive to become familiar with the new language of ICD-10 because i...
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Looking Forward to the Future... Which begins October 1, 2015
html { font-family: "Color Emoji", "Calibri", "Segoe UI", "Meiryo", "Microsoft YaHei UI", "Microsoft JhengHei UI", "Malgun Gothic", "sans-serif"; } We are only about one month away from  implementation of ICD -10. Finally!!   Documentation specificity has been needed for many years throughout healthcare. ICD-9 outgrew the descriptive clinical terms that captures severity of illness and medical necessitymany years ago. We should be very happy that the specifici...
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The Affordable Care Act (ACA) Pt.1 - Welcome to Population Medicine
With the constitutionality of the Affordable Care Act (ACA) recently being upheld by the Supreme Court we must now start working toward the goals of this future direction of healthcare. Namely population medicine and health. Let's begin to look at the potential directions of the future of healthcare that we must now embrace. The Affordable Care Act's premise is to increase the availability of health care coverage to make it more affordable, which it increases accessibility for all US citize...
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12

She Said; She Said

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Hello.   My name is Nicole Duperon Harper, PhD.   My passion – is learning, education and intellectual stimulation.  My inspiration – Healthcare. There are so many various things I’ve seen and conversations I’ve had the privilege to be involved in – I long for more.  More ideas, more perspectives, more insight – more, more, more.  I am currently the Director of Revenue Cycle Operations for a Large Health System in the Midw...
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?? Medicare’s Recovery Audit Contractors (RAC) to pay??
357,000 backlogged appeals awaiting determination in the Office of Medicare Hearings and Appeals (OMHA) has caused Representative Jim McDermott (D-WA), ranking member of the House Ways and Means Health Subcommittee, to voice his concern. In a letter to Department of Health and Human Services (HHS) Secretary Kathleen Sebelius on March 18,2014, he implicated the RAC's and the "Two Midnight Policy" as the "immediate cause" of the backlog and proposed several administrative solutions.
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Posted in: | Tags: Clinical documentation Improvement , Medicare , DENIALS AND APPEALS , physicians , health care compliance , ADMINISTRATORS , RECOVERY AUDIT CONTRACTORS , health care reform | Comments (0) | View Count: (8743)
CMS ANNOUNCES CHANGES IN RECOVERY AUDITOR (RA) PROCEDURES AND “A PAUSE IN OPERATIONS”
On February 18, 2014 CMS announced that they are in the process of “procurement for the next round of Recovery Audit Program contracts.” There will be a pause in operations to allow current RA contractors to complete all outstanding claim reviews and other processes by the end date of the current contracts. This will also allow CMS “to continue to refine and improve the Medicare Recovery Audit Program.”
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Posted in: | Tags: CMS , DENIALS AND APPEALS , RECOVERY AUDIT CONTRACTORS , ADMINISTRATORS , MEDICARE , health care reform , PHYSICIANS | Comments (0) | View Count: (6472)
05

Healthcare will survive October 1, 2014!

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Healthcare will survive October 1, 2014!
Most industry leaders have been working diligently to execute ICD-10 implementation plans – getting through training, tying up loose ends, preparing for testing & successfully avoiding the evident potholes. Will we be prepared??
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Posted in: | Tags: Clinical documentation Improvement , Coding , ICD-10 , HIT , health care reform , health care compliance | Comments (0) | View Count: (524)
Model Notices of Privacy Practices for Health Care Providers and Health Plans Released
The Office for Civil Rights and Office of the National Coordinator for Health Information Technology have collaborated to develop model Notices of Privacy Practices for health care providers and health plans to use to communicate with their patients and plan members. The HIPAA Privacy Rule gives individuals a fundamental right to be informed of the privacy practices of health plans and health care providers, as well as to be informed of their privacy rights with respect to their personal hea...
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Posted in: | Tags: HIPPA , Privacy , Compliance , EHR , Electronic Health Record , HIT , Health Information Technology | Comments (0) | View Count: (1217)
CLINICAL DOCUMENTATION STRATEGY; TAMING THE TEMPEST
And Glinda the Good Witch of the North a beautiful young woman with long, rich red hair and blue eyes, wearing a pure white glistening gown replete with sparkling jewels in her crown and magic wand in hand says in a sweet, reassuring voice… “Turn around, close your eyes, tap your heels together three times and think to yourself……There’s no place like pre- health care reform, There’s no place like pre- health care reform, There’s no place like pre- health care reform.”
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Posted in: | Tags: physicians , nurses , health care reform , case managers , physician documentation , hospital , health care , HIMs , utilization review , revenue cycle professionals , Medicare , compliance , coders , ICD-10 , administration | Comments (0) | View Count: (1833)
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