Social Work Blog

SEPTEMBER 16, 2022

Following a recent update from the Centers for Medicare and Medicaid Services (CMS), NASW has received multiple inquiries regarding telehealth place of service codes (POS) for Medicare, Medicaid and private health insurance companies. CMS revised the description for POS codes 02 and 10 for telehealth.

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Telehealth Medicare Medicaid Clinic 74

Relias

OCTOBER 25, 2021

OTs working in home health can initiate the start of care in more situations beginning in 2022 under changes to the Medicare conditions of participation (CoPs). Under previous rules, an OT was not authorized by Medicare to conduct an initial assessment in home health. OTs Can Conduct Medicare Initial Assessment.

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Medicare Therapist Medicaid Communication 97

Social Work Blog

NOVEMBER 4, 2022

Attention Clinical Social Workers: CMS Seeking Feedback on Good Faith Estimates. Clinical social workers (CSWs) are currently required to give Good Faith Estimates (GFEs) to patients who are uninsured and patients who have insurance but do not plan to use it, [link]. A list of additional questions is available at [link].

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Medicare Medicaid Clinic Social Worker 84

Social Work Blog

SEPTEMBER 8, 2022

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule of the Physician Fee Schedule (PFS) that announced proposed policy and practice changes for Medicare Part B payments beginning January 1, 2023. The proposed changes may impact social workers and other Medicare providers in various settings.

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Medicare Telehealth Mental Health Clinic 40

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% The act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020. Mandatory Telehealth Reporting.

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Medicare Telehealth Medicaid Hospice 52

Relias

NOVEMBER 4, 2021

Successful agencies recognize that long-term success depends on meeting required clinical regulations and having staff with the home health specializations to meet shifting client needs. Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. Increasing agency profitability.

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Medicare Hospice Healthcare Medicaid 52

Relias

JANUARY 11, 2023

For example, less than 20% of Medicare spending is currently value-based. But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030. But as a major difference in how most providers have operated, change has come slowly.

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Medicare Healthcare Medicaid Hospitals 52

Relias

APRIL 18, 2022

When you invest in educating clinicians as wound care specialists, you can put your organization in a stronger business position by: Developing a team with clinical expertise in wound and ostomy care. Increasing reimbursements by effectively treating more clinically complex patients. Develop Clinical Expertise in Wound Care.

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Medicare Hospitals Clinic Medicaid 52

Relias

JANUARY 30, 2024

Healthcare organizations receive scores from the HCAHPS survey , which according to the Centers for Medicare and Medicaid Services, is “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.” Researchers have studied the connection between patient experience and clinical outcomes.

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Healthcare Medicare Hospitals Communication 52

Michigan Social Work

JUNE 16, 2022

In Washington, new legislation to increase Medicare reimbursement rates for clinical social workers has been introduced in both chambers of Congress. These crucial investments would bring hundreds of new professionals into communities across Michigan over the next three years through investing in students, training and research.

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Medicare Mental Health Schools Clinic 52

Social Work Blog

MAY 5, 2023

Clinical Practice: April / May 2023 A new Tips & Tools for Social Workers, CMS 2023 Quality Payment Program for Clinical Social Workers , is available. The QPP allows eligible clinicians who are reimbursed for Medicare Part B services to receive a bonus for improving the quality of patient care and health outcomes.

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LMSW Foster Care Medicare Mental Health 52

Relias

MARCH 1, 2023

One approach that hospital officials are using to manage the readmission risk and avoid Medicare penalties is establishing a preferred SNF network. Short video-based courses that provide a refresher on the assessment and clinical skills necessary to prevent avoidable hospitalization can be helpful.

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Hospitals Medicare Nursing Home Medicaid 52

CAPC

JULY 31, 2023

The GUIDE Model focuses support on family caregivers.

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Medicaid Medicare Clinic 52

Social Workers Speak

APRIL 20, 2023

Karen Bullock is a member of NASW-MA: Medicare tests a solution to soaring hospice costs: Let private insurers run it WUSF Many experts believe that harsh choice between giving up hope and getting help from hospice — along with the arbitrary six-month cutoff — combine to repel many patients who could otherwise benefit.

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Hospice Mental Health Substance Abuse Social Worker 52

Relias

JANUARY 23, 2023

I am a nurse with many years of clinical experience and now a vice president and partner in clinical solutions at Relias. Research cited in our study showed that screening occurred in less than two-thirds of mothers, with considerable variation depending on race, income-level, and Medicaid/Medicare status.

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Depression Patient Safety Mental Health Healthcare 98

Social Workers Speak

APRIL 20, 2023

Karen Bullock is a member of NASW-MA: Medicare tests a solution to soaring hospice costs: Let private insurers run it WUSF Many experts believe that harsh choice between giving up hope and getting help from hospice — along with the arbitrary six-month cutoff — combine to repel many patients who could otherwise benefit.

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Hospice Mental Health Substance Abuse Social Worker 40

Relias

JUNE 19, 2023

According to a 2021 report from the United States Government Accountability Office, Medicare spending on stays for severe wound care declined about 2% from $2.06 billion in fiscal year 2016 to $2.01 billion in fiscal year 2018.

Healthcare 52

Healthcare Rehabilitation Medicare Hospitals 52

Social Workers Speak

AUGUST 26, 2021

COVID created more transparency regarding what we already knew was happening,” said Sonyia Richardson , a licensed clinical social worker who focuses on serving people of color and an assistant professor at the University of North Carolina-Charlotte , where she researches suicide. Susan Pinne, a clinical social worker at St.

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Mental Health Medicare Medicaid Social Worker 40

Relias

OCTOBER 28, 2022

The Centers for Medicare and Medicaid Services (CMS) is ramping up survey scrutiny for hospice this year, training surveyors to focus on interdisciplinary group care planning and coordination of care as part of an emphasis on meeting four core Conditions of Participation. Busy clinical managers can’t bear the documentation burden alone.

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Hospice Communication Patient Safety Clinic 52

Relias

NOVEMBER 16, 2022

In April, the Centers for Medicare and Medicaid Services proposed a $320 million decrease in Medicare payments to skilled nursing facilities for fiscal year 2023. A study published in Value in Health on the cost of chronic wound care for Medicare beneficiaries revealed that nearly 15% of the patients (8.2 billion to $96.8

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Medicare Medicaid Clinic Hospitals 10

Relias

JULY 12, 2022

By arming your care teams with the latest clinical and technical skills and world-class soft skills, you will better prepare them to adapt as needed to meet patients’ future healthcare needs. The results benefit everyone: patients get outstanding care, employees build resilient careers, and your organization thrives.

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Healthcare Hospice Nursing Home Medicare 52

Social Work Blog

JANUARY 5, 2022

We are also advocating on behalf of clinical social workers with key federal regulatory agencies and other stakeholders. Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). Document the GFE in the clinical record. Background on Federal Rule. Timeframes.

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Clinic Social Worker Self-harm Medicare 98

Relias

DECEMBER 13, 2021

An unintended, but positive offshoot of the pandemic is that the crisis highlighted home health’s “very quick and successful adjustments” and “versatility” to serve COVID-19 patients and millions of others served under Medicare, Medicaid, Veterans Administration, and other services. Clinical assessments. Mentorship programs.

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Home Care Healthcare Medicare Medicaid 52

Relias

APRIL 28, 2022

Throughout the cycle, the possibility of errors looms if your staff isn’t up to speed on the complex coding demands and rules set by hospitals, insurers, and the Centers for Medicare and Medicaid Services. How Clinical Documentation Integrity Affects Revenue. of claims between 2016 and the third quarter of 2020.

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Clinic Healthcare Medicare Medicaid 52

Relias

JULY 14, 2023

Recent research and reporting indicate that maternal mortality prevention depends on simultaneously addressing three overlapping areas — clinical, social, and behavioral. mothers have access to a very high standard of clinical care, social factors prevent many others from accessing even the minimum level of care they need.

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Clinic Mental Health Domestic Violence Healthcare 52

Relias

JANUARY 8, 2024

Medicare payment systems link patient satisfaction scores with reimbursement rates, making quality patient care a primary determinant of an organization’s viability and motivating healthcare administrators to implement patient satisfaction strategies. But gaining patient trust isn’t the only benefit of high patient satisfaction scores.

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Healthcare Medicare Hospitals Clinic 52

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. Insufficient Clinical Documentation or Underreported codes. Coding is high value — and in high demand.

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Clinic Justice and Corrections Healthcare Medicare 52

Social Work Blog

DECEMBER 21, 2021

Application to Clinical Social Work Services. Under a new federal rule to protect consumers from surprise health care bills, clinical social workers and other health care provider types must, effective January 1, 2022, provide a good faith estimate of expected charges. Document the GFE in the clinical record. December 21, 2021.

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Medicare Medicaid Clinic Social Worker 98

Social Work Blog

DECEMBER 21, 2021

Application to Clinical Social Work Services. Under a new federal rule to protect consumers from surprise health care bills, clinical social workers and other health care provider types must, effective January 1, 2022, provide a good faith estimate of expected charges. Document the GFE in the clinical record. December 2021.

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Medicare Medicaid Clinic Government 113

Relias

FEBRUARY 1, 2023

Some Medicare Advantage plans are denying authorization for hospitalization. This is happening even though clinical documentation supports medical necessity and the stay meets the ’2-midnight’ rule per CMS guidelines ,” said Jennifer Ward, CRCS, denial specialist supervisor for patient financial services revenue integrity at Sharp HealthCare.

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Healthcare Hospitals Medicare Clinic 10

Relias

AUGUST 9, 2023

Tis the season for evaluating training programs and checking everything twice to make sure you’re on the Center for Medicare and Medicaid Services’ and The Joint Commission’s nice lists. It’s more like stale coffee and the gentle clicking of keys on the computer. Say farewell to paper and hello to efficiency and consistency!

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Engagement Healthcare Communication Medicare 52

Social Work Blog

APRIL 18, 2022

The Centers for Medicare and Medicaid Services (CMS) has released clarifying information about Part 2 of the No Surprise Act, Good Faith Estimates (GFEs). Part 2 focuses on services provided to the uninsured or self-pay patients who receive services provided by clinical social workers in independent practice. Clinical Manager.

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Social Worker Nursing Home Medicare Medicaid 98

Relias

MAY 1, 2022

Because the Centers for Medicare and Medicaid Services will not reimburse healthcare organizations for costs associated with hospital- or facility-acquired pressure injuries, appropriate assessment at the time of admission is vital. Factors spurring legal action often involve communication and behavioral issues as well as clinical skills.

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Healthcare Hospitals Communication Medicare 98

Relias

JULY 20, 2023

­The Centers for Medicare and Medicaid Services (CMS) issued a final rule in August 2022 to improve maternal health outcomes and advance health equity — two of the Biden-Harris Administration’s key priorities. It is important to focus on clinical protocols and reduction in practice variation. Sadly, U.S. rates are continuing to rise.

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Hospitals Medicaid Mental Health Medicare 40

Relias

OCTOBER 10, 2022

Recently, the Centers for Medicare and Medicaid Services’ (CMS) Special Focus Facility Program report listed nursing homes that have not met the CMS’ health care or fire safety standards. Quality care and optimal clinical outcomes. Audit coding and billing to ensure clinical documentation integrity. Staff training and licenses.

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Nursing Home Healthcare Medicare Medicaid 52

Relias

AUGUST 11, 2022

Clinical documentation integrity within this record is essential in both the revenue cycle and patient care processes. It enhances clinical, financial, and administrative planning and performance monitoring. Prioritizing Clinical Documentation Integrity.

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Clinic Administration Healthcare Medicare 52

Relias

OCTOBER 14, 2022

Sparkman, who is Relias Vice President and Partner, Clinical Solutions, Patient Safety and Quality, noted that despite advancements, “The U.S. In its report Improving Access to Maternal Health Care in Rural Communities , the Centers for Medicare and Medicaid Services reported that less than half of U.S.

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Telehealth Healthcare Hospitals Patient Safety 52