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 […]

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 […]

When Pursuing CDI, Using Risk Adjustment Is Vital

As healthcare has moved away from fee-for-service reimbursement models toward a more value-based system, the idea of using risk adjustment to account for individual patient risk and chronic conditions has become far more important for providers seeking to maximize quality of care. In today’s healthcare environment, providers are often required to fight simultaneous battles on […]

Better Outpatient CDI For Emergency Care, Wound Care and Total Knee Replacement

As care is increasingly delivered in an outpatient setting, it is critical that clinical documentation improvement (CDI) programs are developed to ensure compensation for care. “Clinical documentation is at the core of every patient encounter,” says the American Health Information Management Association (AHIMA). The association goes on to say that a meaningful documentation process must […]