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Thought Leadership

When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.

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Medicare Code Edit 20

Coding Changes are Coming, Ensure Your Organization is Ready

For discharges occurring on and after April 1, 2022, coders will have access to new ICD-10-CM and ICD-10-PCS codes. April 1st will also introduce the new Medicare Code Editor (MCE) edit 20 – Unspecified Code Edit. The 2022 IPPS Final Rule stated there would now be coding updates in both October and April. The goal […]

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Insurance Verification and Authorization within Outpatient Therapy

Insurance Verification and Authorization within Outpatient Therapy

Healthcare organizations need to pay attention to the amount of time it takes patients to get insurance verification and authorization completed. If the process takes too long, patients will seek treatment at other facilities even if they were referred to your organization. Insurance Verification and Authorization Benchmark Notwithstanding patient choice, outpatient therapy providers should be […]

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Technical Users’ Guide for the Care Compare Nursing Home

Technical Users’ Guide for the Care Compare Nursing Home Updates

On January 14, 2022, Centers for Medicare & Medicaid Services updated the Technical Users’ Guide for the Care Compare Nursing Home Five-Star Quality Rating System. While this information will be publicly reported starting in January, it will not be used in the Five-Star Quality Rating System until July 2022. Here is what you need to […]

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Period 2 Reporting Portal

Period 2 Reporting Portal is Now Open: PRF Update

It’s the second week of January and the Provider Relief Fund reporting portal is open for Period 2 reporting. The portal will remain open until March 31, 2022 and is for reporting on payments received between July 1, 2020 and December 31, 2020. The layout and design of the portal is unchanged from Period 1, […]

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2022 Physician Fee Schedule Final Rule

2022 Physician Fee Schedule Final Rule: Highlights

Do you know that CMS is making significant changes to split/share and critical care services in 2022? Are your providers aware of the changes? Are they prepared to modify the documentation of these services? Are your coders prepared to report the required modifier? On November 2, 2021, CMS released the 2022 Physician Fee Schedule Final […]

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Impairment Diagnoses in Outpatient Physical and Occupational Therapy

Impairment Diagnoses in Outpatient Physical and Occupational Therapy

How would you like to reduce medical necessity denials in your outpatient therapy services? One way to do that is to ensure your therapists are capturing the impairment diagnoses in the plan of care. What is Impairment Diagnoses? Chapter 15 of the Medicare Benefit Policy Manual states: “a diagnosis (where allowed by state and local law) […]

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Pile of blue masks | Vaccine Mandates in the Workplace | COVID-19 Vaccine Mandates in the Workplace | COVID-19 Vaccine Mandate

On-Demand Webinar: COVID-19 Vaccine Mandate in the Workplace

President Biden’s administration recently announced its Path Out of the Pandemic action plan which included specific guidance around a COVID-19 vaccine mandate. The action plan calls for employers with 100 or more employees to require employees to be vaccinated or submit to weekly tests, as well as requiring vaccinations for federal employees, contractors, and hospitals […]

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Skilled Nursing Facilities Vaccine Mandate

Skilled Nursing Facilities Vaccine Mandate

Last week there were two new rules issued by the Biden administration regarding vaccine mandates. The Center for Medicare and Medicaid Services (CMS) released an interim final rule (IFR), along with the Emergency Temporary Standards released by the Occupational Safety and Health Administration (OSHA). Providers Involved: Ambulatory Surgical Centers Hospice Agencies Psychiatric Resident Treatment Facilities […]

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Asset Approach

The Asset Approach in a Post-COVID-19 World

by Joseph Evenson, Staff Accountant In the business valuation world, due diligence is crucial now more than ever. The “same as last year” mentality is no longer acceptable until we have a few years of stability under our belts. COVID-19 has been, and continues to be, a unique challenge for businesses and business owners. Some […]

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Patient Financial Obligation

Patient Financial Obligation in Outpatient Therapy

By John Britt, Senior Manager Outpatient therapy is a recurring service; for example, a routine plan of care is often 12 visits over 30 days. With rising co-pays and deductibles, patients are increasingly choosing less care, meaning less visits, than the therapists are recommending in the plan of care because of financial constraints. Your department […]

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Medicaid Managed Care Organizations

Kentucky Medicaid Managed Care Organizations Changes

Pursuant to KRS 205.640 and managed care contracts, Kentucky Medicaid Managed Care Organizations (MCOs) are required to provide a Paid Claims Listings (PCLs) to all in-state hospitals. The department and each Medicaid Managed Care Organization shall supply a Paid Claims Listing (PCL) to each hospital within ninety (90) days of the last day of the […]

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Income Approach

The Income Approach in a Post-COVID-19 World

By Brandon Nowling, CPA, CVA, Senior Accountant COVID-19 has created much uncertainty for business owners who are considering buying or selling a business during these troubling economic times. Many owners who are considering selling are asking themselves, “What will the lasting impact be on my business? Will the decline in revenue during 2020 impact my […]

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Volume Decrease Adjustment

Volume Decrease Adjustment: What You Need to Know

The Volume Decrease Adjustment (VDA) is a lump sum payment available to Sole Community Hospitals (SCH) or Medicare Dependent Hospitals (MDH) who have experienced more than a 5% decrease in total discharges of inpatients as compared to the immediately preceding cost reporting period. The decrease in total discharges must be caused by circumstances that are […]

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referral development for outpatient therapy

Referral Development within Outpatient Physical and Occupational Therapy

When looking at your Outpatient Physical and Occupational Therapy departments, have you noticed a decrease in the volume of outpatient services? At Blue & Co. we often find that many hospitals and hospital systems have viable candidates for outpatient therapy services but are being seen by another healthcare organization due to a lack of a […]

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Final Rule FY 2022 for Skilled Nursing Facilities

Fiscal Year (FY) 2022 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (CMS-1746-F) was released on July 29, 2021 by the Center for Medicare and Medicaid Services (CMS). Here is what you need to know about the Final Rule for Skilled Nursing Facilities. Thanks to the stakeholder comments received by the CMS they […]

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Webinars

How to Manage Clinical Validation Denials

In the past several years, hospitals have continued to feel the impact on revenue from Clinical Validation Denials (CVD). The need for a robust CDI team to capture support for clinical indicators while the patient is still in house is more imperative than ever. The other overwhelming piece for revenue cycle teams to manage is […]

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Margin Improvement: Optimizing Financial Performance

Ensuring the long-term financial viability of a health system requires constant attention to the operating statement. This involves assessing the current state of your healthcare organization and critically comparing the current condition to industry and/or internal benchmark standards. Ultimately, this assessment assists management implement an ongoing margin improvement process to increase the likelihood of achieving […]

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Length of Stay and How it Impacts Hospitals

For hospitals, managing the length of stay is not a new concern. What has changed, however, for many hospitals is the level of attention and focus on it. At the height of Covid-19, many hospitals were merely in “survival mode” and were doing everything they could to meet the patient’s needs. Born out of necessity, […]

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Promoting Patient Access in a Productivity Compensation Environment

Hospital systems and healthcare organizations that employ physicians have struggled to promote patient access. Access issues may result from misaligned compensation and organizational goals, practice operations process or capacity issues as well as a host of other reasons. Compensating physicians on purely a productivity basis may be helpful from a billing and monitoring perspective, but […]

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Capital Efficiency Concepts: How to Evaluate Capital Purchases

Rising interest rates and historic inflation are impacting hospital purchasing decisions. Using capital efficiency concepts in making hospital purchasing plans is as important as ever. What is Capital Efficiency? Capital efficiency refers to how effectively a hospital deploys its resources to generate returns. In the context of fixed assets and software purchases, capital efficiency involves […]

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Feasibility Studies: Helping Organizations Make Informed Decisions

Conducting a feasibility study is an essential step in determining the viability of implementing a new healthcare program, service, or project. These studies help healthcare organizations assess the potential risks and benefits of their proposed projects before investing significant time, money, and resources into planning for them. Feasibility Studies 101 Feasibility studies typically involve an […]

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