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Billing Compliance, Q Codes, Edits and Audits: Compliance in the Home Health Industry an Update

CMS revised the requirements on “April 19, 2013 to delete “and indicating whether services were added to the HH plan of care by a physician who did not certify the plan of care” from the Provider Action Needed” section of MLN Matters numberMM8136 Revised...

Published Tue, May 05 2013 6:40 PM by Select Data

Filed under: CMS, Home Health, Compliance, CMS Guidelines, Billing, Q-Codes, Billing Compliance

HIPAA Rules and the HITECH Act-Patient Privacy

Compliance officers were awaiting the Office of Civil Rights (OCR) final rules on Breach Notification, Enforcement, and the modification to Privacy and Security Rules of HIPAA HITECH. Now that we have the regulations, it is time to review the basics in...

Published Mon, Apr 04 2013 4:37 PM by Select Data

Filed under: Home Health, Select Data, Compliance, OCR, Office of Civil Rights, HIPPA, PHI, HIPPA HITECH, personal health information, Corporate Compliance

Billing Compliance, Q Codes, Edits and Audits: Compliance in the Home Health Industry

Statistical Data Every time an OASIS is submitted to the state, portions of it may be parsed out to state, regional, and Federal groups such as the HEAT, MAC review groups, and Federal special projects in the DOJ and FBI. That means that when a review...

Published Thu, Mar 03 2013 7:02 PM by Select Data

Filed under: clinical data, Home Health, Compliance, Billing, PECOS, edits, Code 37236, Q Codes, 2CJK, NHIC, Audits, MUEs, Code 37237, 1BGP

Medical Comedy Relief: The Doctor Visit

Published Thu, Mar 03 2013 7:30 AM by The Doctor Weighs In

Filed under: Health IT, Health information technology, Compliance, Patient Engagement, Doctor-patient relationship, prevention, Health care professionals, Pain, humor in medicine, Lisa Suennen, Venture Valkyrie, Other stuff, Patient experience, patient accountability

Women’s Health Must be Priority for States’ Health Exchanges

Women are finally getting the respect they deserve. According to a new report from the George Washington University School of Public Health and Health Services (SPHHS), women’s health issues are key to the health of the nation and should be a major consideration...

Published Wed, Mar 03 2013 10:44 AM by Healthcare Intelligence Network

Filed under: Health IT, HIT, EHRs, Compliance, e-health, care coordination, health insurance exchanges

Free Presentation Slides – “A Survival Guide: The “Must Haves” for a Corporate Compliance Program

With the focus of our educational articles in March being on Compliance in Home Health Care, we are excited to put up these slides from a recent presentation given by Susan Carmichael on The Must Haves for a Corporate Compliance Program. Download...

Published Tue, Mar 03 2013 2:11 PM by Select Data

Filed under: Home Health, Compliance, Corporate Compliance, Presentations

Infographic: The 5 C’s of Healthcare for 2013

2013 will be the most important year in U.S. healthcare industry in modern history thus far, according to Deloitte. The nation’s fiscal challenges and the healthcare industry’s bulk are on a collision course, says the consulting firm, predicting that...

Published Mon, Mar 03 2013 1:21 PM by Healthcare Intelligence Network

Filed under: Compliance, Healthcare Costs, Healthcare Trends, Consumer-Driven Healthcare, Infographics

Infographic: Smoking Statistics for U.S. Adults with Mental Illness

People with mental illness smoke at much higher rates than the U.S. population as a whole, but are as interested in quitting as other smokers and can quit successfully with more intensive smoking cessation treatment. Those are the conclusions of a recent...

Published Fri, Mar 03 2013 12:35 PM by Healthcare Intelligence Network

Filed under: Compliance, disease management, Behavioral Health, smoking cessation, Population Health Management, Infographics, mental illness

RWJ Forum on Reducing Readmissions: “Hospital Discharge is Tipping Point”

In the increasingly hot-button realm of reducing avoidable Medicare rehospitalizations, the handoff from hospital to home has become the tipping point, agreed expert panelists at this week's Care About Your Care forum presented by the Robert Wood...

Published Fri, Feb 02 2013 4:00 PM by Healthcare Intelligence Network

Filed under: Medicare, Uncategorized, Compliance, healthcare reform, Affordable Care Act, Case Management, Reducing Readmissions, Hospital Readmissions, Transitions in Care, patient satisfaction, Population Health Management, care transitions

Coding, Homebound Status, and Awareness of Common Edits: Paid But Will You Retain Your Revenue? An Update.

No matter which MAC or RAC reviews your agency, high risk probes are on the rise. The intermediaries are mandated by CMS to monitor areas of greater risk. The RACs are paid by contingency on aberrant findings. When either finds trends of concern they...

Published Tue, Jan 01 2013 11:54 AM by Select Data

Filed under: CMS, Home Health, Compliance, OIG, ICD-10-CM Coding, RACs, MACs, NAHC

Proper Coding, Homebound Status, and Awareness of Common Edits: Paid But Will You Retain Your Revenue? An Update.

No matter which MAC or RAC reviews your agency, high risk probes are on the rise. The intermediaries are mandated by CMS to monitor areas of greater risk. The RACs are paid by contingency on aberrant findings and their algorithms are making findings easier...

Published Tue, Jan 01 2013 11:54 AM by Select Data

Filed under: CMS, Home Health, Compliance, OIG, ICD-10-CM Coding, RACs, MACs, NAHC

The Role of Compliance : Home Health and Hospital Readmissions

This is THE topic one sees everywhere; trade journals, conferences, CMS, MLN, State Alerts, Home Health Associations. This topic is no longer just an operational and financial issue. Boards of Directors are looking to the Corporate Compliance Department...

Published Tue, Jan 01 2013 2:06 PM by Select Data

Filed under: hipaa, CMS, Home Health, Compliance, hospitals, ACO, Affordable Care Act, ACA, MLN, Affordable Care Act (ACA), HIPPA, Patient Centered Medical Homes, Hospital Readmission Reductions Program (HRRP), Corporate Compliance, (HRRP), Transitional Care Initiatives, Hospital Readmission Reductions Program

Summary of the CMS Released 2013 Final Rule

Market Basket and Payment Rate Update On November 2, 2012, CMS released the Medicare Home Health Final Rule for the Home Health Prospective Payment System 2013. The proposal includes the 2013 Market Basket Index (MBI) update of 2.3%, the required 1 point...

Published Tue, Nov 11 2012 5:07 PM by Select Data

Filed under: Medicare, CMS, Home Health, Select Data, Compliance, Face to Face Encounters, ACA, Affordable Care Act (ACA), Therapy, NAHC, ICD-9CM Coding, M1024, Market Basket Index, LUPA Rates

Long Term Care in Home Health Possibility Due to Class-Action Suit

A nationwide class-action lawsuit brought by Medicare beneficiaries would eliminate the present CMS policy requiring Medicare beneficiaries to show a likelihood of medical and/or functional improvement before Medicare will pay for skilled nursing, physical...

Published Mon, Nov 11 2012 5:40 PM by Select Data

Filed under: Medicare, CMS, Home Health, Compliance, Legislation, long term care, Medical Benefit Policy Manual

Mission Not Impossible: Healthcare Reform After the Election

Published Sat, Nov 11 2012 4:57 AM by The Doctor Weighs In

Filed under: accountable care organizations, ACOs, Compliance, Patient Engagement, Personal Health Record, diabetes, Mitt Romney, Patient Safety, Innovation, Regulation, healthcare reform, Sustainability, Obesity, Nutrition, exercise, PPACA, Healthcare Costs, Politics, People in healthcare, Health care professionals, investors, Patient Protection and Affordable Care Act, Innovation/innovative companies, Payment, Health care & health policy, Politics & public policy, Medicine: wellness & disease, Obamacare, President Obama, Lisa Suennen, Venture Valkyrie, Change Management, RETAIL HEALTH, Public sector, psilos, health insurance exchanges, Wade Roush, pay for performance, Startups, consumer protection, EMPLOYERS, Health Economy, preventative measures, health care analytics, health care data, fee-for-service reimbursement, patient accountability, avoid readmissions, improved healthcare efficiency, rewards, venture capitalists, MARKETPLACE, radical change, cutting PBS funding, value in health care, health care technology, healthcare and economy, health entrepreneurs, down economy, chronic conditions, incentives in health care, access to medical care

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