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To Query or Not to Query…

To Query or Not to Query…

Physician Query: What is it? Physician queries have been used by Health Information Management (HIM) and Clinical Documentation Improvement (CDI) professionals in hospitals, but physician queries can be used in any setting. A physician query is a communication between...
U Can’t Touch This!

U Can’t Touch This!

MC Hammer’s song title, “U Can’t Touch This” comes to mind when I think about ill-doers wanting to steal data and demanding us to pay in order to retrieve and access our own data files! Cybersecurity and Infrastructure Security Agency (CISA) defines Ransomware, “as a...
Medical Review Under PDPM

Medical Review Under PDPM

CMS issued their updated their guidance to Medicare Administrator Contractors (MACs) on November 15, 2019 regarding Medical Review Instructions related to Skilled Nursing Facilities in Publication 100-08 Medicare Program Integrity, Transmittal 924. The effective date...
SNF Requirements of Participation

SNF Requirements of Participation

In October 2016, the Centers for Medicare and Medicaid Services (CMS) published a final rule revising for Medicare and Medicaid requirements of participation (RoP) for nursing facilities. In the July 18, 2019 Federal Register, CMS proposed the rule that will reform...