Featured Article
April 2, 2020
Communities Work to Manage COVID-19 and Homelessness
By Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP
COVID-19 has populations at risk for all determinants, especially the “housing compromised.” Homelessness was 2019’s top social determinant of health (SDoH). 2019’s Annual Point in Time Count showed almost 570,000 people living on the street nationwide. With 2020’s results pending, ongoing increases are expected. COVID-19 has populations at risk for…
Patients must continue to be discharged to an appropriate setting, per CMS. As hospitals continue in their struggle to treat patients for COVID-19, the illness caused by the novel coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has modified its requirements for discharge planning. According to Ronald Hirsch,…
Rural America is facing a healthcare crisis. EDITOR’S NOTE: The global pandemic of the coronavirsus is further exacerbating the rural health crisis. This is the first in a series of reports on rural health. Rural Americans, on average, are six years older than their urban counterparts, and make up about…
On March 13, the Centers for Medicare & Medicaid Services (CMS) issued blanket waivers that will impact Inpatient Rehabilitation Facilities (IRFs) as well as other Post-Acute Care (PAC) settings. The blanket waivers, which do not require any special request to be filed, will allow IRFs to admit patients to IRF…
March 5, 2020
Determining When Copay Waivers Are Allowed
By Sean M. Weiss, CEMA, CMCO, CPMA, CPC-P, CMPE, CMPM, CPC-P
More education is needed to explain when waivers are allowed. The age-old question of “can we offer cash-pay discounts, professional courtesy, and/or the waiver of co-payments or deductibles?” continues to be as relevant today as it was two decades ago. There have been a lot of opinions shared over the…
Matthew Albright was Acting Deputy Director of the Office of E-Health Standards and Services for CMS. Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now the chief legislative affairs officer at Zelis, will join Monitor Mondays as a permanent panelist beginning Monday, March 2. The announcement was…
February 20, 2020
Custodial Admissions from the ED: Major Issue Nationally
By Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV
Health systems are grappling with custodial/social admissions from the ED. A specific quandary is playing out in emergency departments (EDs) all over the country, and no one seems to have a clear answer on how to address it. The situation? Patients presenting to EDs because they are unable to care…
February 13, 2020
Differentiating Between Professional and Facility ED Coding
By David A. McKenzie, CAE
It is important to differentiate between ED professional and ED facility coding, and how levels of service are assigned. EDITOR’S NOTE: Recently, RACmonitor published articles referencing UnitedHealthcare/ Optum’s notice that they were changing the way they process emergency department (ED) claims, beginning April 1, 2020, along with how professional and facility…
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