In addition, ConnectiCare’s claims payment system will adjudicate claims based on CMS (Centers for Medicare & Medicaid Services) and NCCI (National Correct Coding Initiative) edits. ConnectiCare considers coding edits that are based on industry sources, including but not limited to CPT guidelines...
• Medicare / Medicaid Elder care planning is very complicated. “Information” does NOT equal “knowledge.” Information is extensive and available at your fingertips – in libraries and on the Internet. But competent working knowledge takes years of hands-on experience, and this is exactly what...
RosenbaumS.CRITICAL CARE NURSING QUARTERLY
One person's donation can save the lives of up to eight people and enhance the lives of 50 more. The Centers for Medicare & Medicaid Services mandates that every U.S. hospital refer all deaths and imminent deaths to its designated OPO in a timely manner. When usin...
In response, the Centers for Medicare & Medicaid Services (CMS), which covers most U.S. dialysis treatment, penalizes both hospitals and dialysis clinics for readmissions among these patients [3,4,5]. Most dialysis clinics and hospitals do not belong to the same healthcare system or share ...
Amazon, a relative newcomer to the online pharmacy world, is moving aggressively. Its drug selection is somewhat limited as yet, and its generics’ prices, though competitive, are not generally the lowest. However, if you take some of the commonest generics, are not a Medicare or Medicaid re...
Medicare, Medicaid is not enough. Once you have worked so hard all of your life to earn your pension unless you’ve made a sustainable amount then you’re stuck with state run care. (I will not get on my soapbox about that issue). ...
(Center for Medicare & Medicaid Services) readmission penalty under “Obamacare”, a.k.a. Patient Protection and Affordable Care Act (PPACA), will be able to establish direct contact with discharged patients within hours of the...
Abstract:The need for automated assistants for healthcare is well-established. Medical providers benefit from an automated assistant who helps to triage patients, summarize changes in a patient’s condition, and suggests possible drugs or procedures. Similar needs arise in home healthcare, where autom...
3) timely responses to clinical data requests to help payers comply with Centers for Medicare and Medicaid Services (CMS) regulations; and 4) more consistent, higher quality outcomes. At the same time, providers need 1) timely information on gaps in care; 2) guidance on Hierarchical Condition ...