Monthly Archives: August 2020
How does Transitional Care Management (TCM) Work?
Transitional Care Management (TCM) encompasses the 30 days of a Medicare beneficiary’s post-discharge period from an inpatient acute care or psychiatric hospital, long-term care hospital, skilled nursing facility or inpatient rehabilitation facility. It focuses on helping the patient make a … Read Full Post
Group Homes: Another Viable Long-Term Care Business
Inquiries to us from prospects about Group Homes have increased considerably in the last few months, and it seems like a good time to review the parameters to see if this is a viable business opportunity for you. A Group … Read Full Post
What We’re Reading – Debunking Common PDGM Primary Diagnosis Myths
The Patient-Driven Groupings Model (PDGM), model focuses more heavily on clinical characteristics as expressed through coding, is a big change for home health agency payments this year. In PDGM, the principal diagnosis code reported on the home health claim assigns … Read Full Post
What We’re Reading – Three ways healthcare facilities are rebounding from COVID-19
The pandemic has been stressful for every industry but healthcare has been hard hit for a few reasons: providers still need to treat patients, but some of those patients may be scared to go to the doctor’s office or visit … Read Full Post
CMS Makes Changes to Telehealth Billing
This is a follow-up to an earlier blog about the Centers for Medicare and Medicaid Services’ (CMS) expanded provisions for coverage of telehealth (TH) visits for Medicare beneficiaries. CMS recently added additional billing codes to its approved list, and clarified … Read Full Post
The DOJ Targets MA Plans
The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) reported that a study conducted in 2019 revealed, “Unsupported risk adjusted payments are a major driver of improper payments in the Medicare Advantage (MA) … Read Full Post
MACs Resume Medical Review on a Post-Payment Basis
To protect the Medicare Trust Fund against inappropriate payments, Medicare Administrative Contractors (MACs) are resuming fee-for-service medical review activities. Beginning August 17, the MACs are resuming with post-payment reviews of items/services provided before March 1, 2020. The Targeted Probe and … Read Full Post
CMS Approves COVID-19 Counseling
When patients are tested for COVID and are awaiting results – or if they’ve tested positive – research shows virus transmission is reduced by 86% if these patients self-isolate early. For this reason, CMS recently clarified that counseling, which includes … Read Full Post
What We’re Reading- How effective and important are one-on-one discussions with direct reports
What can you accomplish by conducting one-on-one meetings and making them a standard practice in your organization? This article delves into the positive impact these interactions can have on helping your team to thrive. Utilizing this practice becomes a great … Read Full Post