The Centers for Medicare and Medicaid Services (CMS) has issued revised requirements to auditors for reviewing pre- and post-payment claims when EHR templates are used. While CMS does not specifically prohibit or endorse the use of EHR templates, it has instructed auditors to take a closer look at claims involving the use of templates to make sure all services are properly documented.
Though the transition to the more granular ICD-10-CM/PCS code set may help, documentation processes at most hospitals will need an overhaul to support the type of pay-for-outcomes coding needed to reflect the care delivered and the severity of illness for patients.
The US Department of Labor (DOL) has extended a program to better identify industry-recognized credentials that businesses look for when recruiting, hiring, promoting, and retaining employees. AHIMA credentials are being considered for the list, which will be integrated into DOL’s CareerOneStop certification database.
When DRGs were introduced in the early 1980s, they dramatically changed the role of HIM professionals—thrusting them into the center of revenue cycle management. Another paradigm shift in payment systems is on the horizon with pay-for-outcomes.
Following up on a requirement of the American Recovery and Reinvestment Act (ARRA) of 2009, the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) recently released guidance on how to de-identify personal health information in accordance with the HIPAA privacy rule.