Archive: 25 June 2020

Hospital Outpatient Departments: Effective July 1, 2020 you must request prior authorization for certain hospital Outpatient Department (OPD) services

For dates of service beginning July 1, 2020, you must request prior authorization for the following hospital Outpatient Department (OPD) services:

  • Blepharoplasty
  • Botulinum toxin injections (when paired with specific procedure codes)
  • Panniculectomy
  • Rhinoplasty
  • Vein ablation

Medical necessity documentation requirements remain the same and hospital OPDs will receive a decision within 10 days.

While only the hospital OPD service requires prior authorization, CMS wants to remind other providers that perform services in the hospital OPD setting that claims related to/associated with these services will not be paid if the service requiring prior authorization is not eligible for payment. These related services include, but are not limited to, anesthesiology services, physician services, and facility services. Only associated services performed in the hospital OPD setting are affected. Depending on the timing of claim submission for any related services, claims may be automatically denied, reviewed, or denied on a postpayment basis.

For botulinum toxin injections, consult the list of codes that require prior authorization for more details. Generally, the use of botulinum toxin injection codes paired with procedure codes other than 64612 or 64615 will not require prior authorization under this program.

Saince announces the launch of tele-medicine feature within its clinical documentation solution

Doc-U-Scribe clinical documentation solution now comes integrated with tele-medicine workflow. Physicians and administrators can create tele-consultation sessions with patients seamlessly from within the application. This process eliminates the need for providers to use separate solutions – one for clinical documentation and another for video session.

The COVID-19 public health crisis has accelerated the use of tele-medicine solutions among healthcare provides across the nation. However, many small hospitals and physician offices do not have access to a single solution that takes care of all their needs. Physicians are forced to use multiple solutions to complete their tele-medicine workflow. They are often finding this process frustrating and cumbersome.

Doc-U-Scribe clinical documentation solution which is used by hundreds of hospitals and physician offices across the country provides an integrated and seamless workflow for clinical documentation as well as tele-medicine.   This new HIPAA compliant tele-medicine solution can cut costs, increase efficiency, and improve physician satisfaction significantly.

Saince announced that this new feature will be available to all their existing customers immediately. Saince also announced that with their plug and play model, any new hospital or physician office can be up and running with their tele-medicine program within 48 hours.

Pandemic – Peril and the promise

The world right now is hurting. And it is hurting really bad. There is a lot of physical, emotional, and economic pain all around. This pain is accentuated with fear. Fear of facing the unknown. Fear of being helpless. Health workers are helplessly watching their patients die in front of their eyes. Children are helplessly watching their parents succumb on FaceTime. The world is now firmly in a grip of fear and gloom.

But behind all this fear and sadness I see hope. I see promise.

I see hope because whenever humanity faced a calamity in the past, either natural or man-made, when it came out on the side, the world became a much better place. For everyone. Each and every event that we faced in the past, be they world wars or natural disasters, brought a lot of pain along with them but after the event they also elevated humanity as a whole.

The Gita, the holy book of Hindus, says that good and bad are two sides of the same coin. One cannot exist without the other. Sort of Yin and Yang of the Chinese philosophy.

This pandemic brought a lot of pain. It pushed a lot of people out of business. More than 40 million Americans lost their jobs. Food lines were unimaginably long.  Everyone is scared. Everyone is hurting in some way or the other. But coming out of all this suffering and pain, I’m seeing an increased feeling of compassion among people. Out of this common suffering I see camaraderie that I never saw before. Unemployment made people look deeper within themselves. The whole climate was emotionally charged.

Then George Floyd died. That triggered an outpouring of emotion. People spontaneously took to the streets, not just in big cities but also in small towns and remote corners. Not only here but all over the world. It united us as a humanity. We felt other person’s pain like we never felt it before. We felt compassionate. We saw the long-standing inequalities in the system. We started on a path to fix it. Events like George Floyd’s death happened before the pandemic too. But the reaction was sporadic. It was temporary. But this time it is different. There is something in the air this time that smells different. We are embarking on a path to make America a better nation than it already is. As a human race, we are starting to feel more united than before.

This time it is different. The scientific community is breaking down borders and collaborating in an unprecedented manner.  They are tearing apart bureaucracies. Putting aside their personal agendas. Working fearlessly and tirelessly towards a common goal for the benefit of humanity. They are realizing the power of cooperation and sharing. Governments are as usual trying to put brakes on this by making it a competitive race. I am hoping that better sense will prevail.

The earth is healing as well. We are now more open to noticing how we have been plundering the natural resources all these years. We have already reached the tipping point in climate change. We were almost at a point of no return. With this pandemic, we hit the pause button. We are seeing palpable change even in this short period when we hit the brakes on our emissions. I am hopeful that as a human race we can continue to let the planet heal.

Families are healing as well. Families are spending time together. They are talking with each other. They are having verbal conversations instead of texting to each other from across the room. They are eating together, playing together, staying together and coming together. When families stay together, communities stay together. When communities heal, nations heal.

Fighting and terrorism across the world has come down quite a bit. In this process a lot of lives has been spared. I hope they use this time to introspect and come together because the virus does not play favorites. When there is a common enemy, everyone comes together.

Hence, I see promise on the other side of this pandemic. To deliver a bundle of joy, the mother goes through a lot of pain.

I am optimistic. I am hopeful. I am human.