PPV: Audit postacute transfers to ensure proper payment
HIM Connection, July 16, 2007
Want to receive articles like this one in your inbox? Subscribe to HIM Connection!
CMS has edits in place to alert your facility when it inappropriately receives the full DRG payment following a transfer from your hospital. This may occur when a patient--unbeknownst to you--seeks additional care after being discharged, resulting in a compliance and payment problem.
However, there is also a reimbursement angle to postacute transfers. If you transfer a Medicare patient to another facility or agency for care, and he or she does not receive the intended postacute care, your facility receives a lower DRG payment--even though you are entitled to receive the full amount. Are you tracking all of the reimbursement that you lose when you transfer patients and they don't receive that subsequent care?
Editor's note: For more information on how to audit postacute transfers, click here. Subscribers to Briefings on Coding Compliance Strategies can read the full article in the July 2007 issue. You can also purchase this article for $10.
Want to receive articles like this one in your inbox? Subscribe to HIM Connection!
Related Products
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Capturing all necessary codes for IUD insertion and removal can be challenging
- QA:Coding multiple initial infusions
- News and briefs: Oklahoma Osteopathic Association against residency bill change
- HIPAA Q&A: Level of encryption needed for email
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- Q&A tackles coding questions about injections and infusions
- Joint Commission Center announces handoff communication solutions
- Inside best practice: Reduce patient falls with a stoplight
- Identify modifiable risk factors to prevent patient falls
- Searched