HCPro: Providing Information to the Healthcare Compliance, Regulation, and Management Industry - www

Time 2020-06-21 06:07:16

Web Name: HCPro: Providing Information to the Healthcare Compliance, Regulation, and Management Industry - www

WebSite: http://www.hcpro.com

ID:6477

Keywords:

the,Healthcare,Compliance,

Description:

HCPro is dedicated to providing the highest-quality, need-to-know information in revenue cycle management, hospital accreditation, nursing, long-term care, medical staff credentialing and privileging, medical coding and billing, and more. Medicare health plans, which include Medicare Advantage (MA) plans such as Health Maintenance Organizations, Preferred Provider Organizations, Medical Savings Account plans and Private Fee-For-Service plans Cost Plans and Health Care Prepayment Plans, must meet the requirements for grievance and appeals processing under Subpart M of the Medicare Advantage regulations. For a detailed discussion of the Medicare managed care grievance and appeals processes, click here.Plans and providers have certain responsibilities related to notifying beneficiaries of Medicare appeal rights. If a Medicare health plan denies service or payment, in whole or in part, the plan is required to provide the enrollee with a written notice of its determination. Additionally, Medicare health plan enrollees receiving covered services from an inpatient hospital, skilled nursing facility, home health agency, or comprehensive outpatient rehabilitation facility have the right to a fast, or expedited, review if they think their Medicare-covered services are ending too soon. New cards will no longer contain Social Security numbers, to combat fraud and illegal useThe Centers for Medicare Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019. Today, CMS kicks-off a multi-faceted outreach campaign to help providers get ready for the new MBI. Having taken time out for retraining and internal audits, contractors may resume initial-phase reviews of Medicare reimbursement claims for short-stay inpatient hospital care, CMS says. Q: Did something change with the observation services Composite APC in 2016? The director of patient financial services says we no longer receive payment for it. It s an unfortunate part of healthcare today the lawsuit. Are you ready if one is filed against your organization? Q: Our radiology department is requesting that we add a new modifier to their charge description master (CDM), modifier CT (computed tomography [CT] services furnished using equipment that does not meet each of the attributes of the National Electrical Manufacturers Association [NEMA] XR-29-2013 standard). They want this added to the CT scan line items, but they are not sure if it is for all of the items or only certain ones. Can you provide more information that might help us know how to proceed? Logging in allows you to read your e-Newsletter subscriptions and customize your HCPro experience. Login Help Username: Find the training and revenue cycle information and tools you need to meet the unique needs of your clients.Our consultative approach and client success team provide the support you need grow your business with a true partnership.

TAGS:the Healthcare Compliance 

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HCPro is the leader in providing information to the healthcare compliance, regulation, and management industry. HCPro offers expert advice and solutions in most aspects of healthcare, including Joint Commission survey readiness, accreditation, CMS, medical records, HIPAA, credentialing, patient safety, finance, corporate compliance, nursing, case management, and long-term care.

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