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.

Psychotherapy 98

Psychotherapy Medicare Social Worker Nursing Home 98

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. Reducing the number of hospital- or facility-acquired pressure injuries, which are nonreimbursable.

Medicare 52

Medicare Clinic Hospitals Medicaid 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. According to the program, hospitals with higher HCAHPS scores earn higher reimbursements.

Healthcare 52

Healthcare Medicare Hospitals Clinic 52

Relias

APRIL 10, 2025

The Centers for Medicare and Medicaid Services (CMS) issued the Emergency Preparedness Rule to provide a national framework for healthcare organizations to improve their readiness for emergencies. This regulation established consistent emergency preparedness requirements for Medicare and Medicaid providers and suppliers of all types.

Healthcare 52

Healthcare Medicare Medicaid Psychiatric 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.

Medicare 52

Medicare Healthcare Medicaid Hospitals 52

Relias

FEBRUARY 28, 2025

Key sources of IHS funding The IHS is primarily funded by federal appropriations, along with grants, Medicaid and Medicare reimbursements, and third-party billing. Medicaid and Medicare reimbursements Tribal health programs can enroll as Medicaid and Medicare providers to receive reimbursements for eligible services.

Healthcare 52

Healthcare Medicare Medicaid Substance Abuse 52

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. Cap on Negative Wage Index.

Medicare 52

Medicare Telehealth Hospice Medicaid 52

Relias

JANUARY 30, 2024

As they consider new ideas to raise patient satisfaction, healthcare leaders must have an understanding of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring system that evaluates these efforts. Researchers have studied the connection between patient experience and clinical outcomes.

Healthcare 52

Healthcare Medicare Hospitals Communication 52

Relias

MARCH 12, 2025

Whether its skilled nursing facilities, hospitals, or home health agencies, regulatory bodies require that healthcare providers demonstrate competency in delivering patient care. Rather than just testing knowledge, these evaluations measure how well employees apply their skills in a clinical setting.

Patient Safety 40

Patient Safety Healthcare Medicare Clinic 40

Relias

MARCH 5, 2025

These options have proven effective in clinical trials, however, IV infusions take 40-60 minutes to complete. For non-Spravato ketamine treatments, many clinics administer ketamine in-house, offering direct oversight from a provider. Medicare Part D patients must: Show they are not eligible for Low-Income Subsidy (LIS).

Patient Safety 40

Patient Safety Medicare Treatment Planning Administration 40

Relias

AUGUST 11, 2022

Clinical documentation integrity within this record is essential in both the revenue cycle and patient care processes. According to the Journal of AHIMA , unresolved claim denials cause an average annual loss of $5 million per hospital. It enhances clinical, financial, and administrative planning and performance monitoring.

Clinic 52

Clinic Medicare Healthcare Administration 52

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.

Hospice 52

Hospice Communication Clinic Patient Safety 52

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.

Home Care 52

Home Care Hospice Healthcare Medicare 52

Relias

MAY 6, 2025

Without a loyal patient base, most of these clinical centers will be plagued by growing existential resource issues. In fact, one report by the American Hospital Association found that an overwhelming 94% of physicians think running a practice has become more financially and administratively difficult.

Healthcare 40

Healthcare Administration Communication Medicare 40

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. Emergency Providers at In-Network Facilities.

Clinic 98

Clinic Social Worker Self-harm Psychotherapy 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. Those types of complications from hospital-acquired pressure injuries are linked to almost 60,000 U.S.

Healthcare 98

Healthcare Hospitals Communication Medicare 98

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.

Depression 98

Depression Patient Safety Mental Health Medicare 98

Relias

OCTOBER 14, 2022

No hospitals or birth centers offering obstetric care. While still having too few hospitals/birth centers, an increase to over just 60 OB providers per 10,000 births would change a county’s designation from maternity care desert to low-access. This version includes additional information for hospitals and health systems.

Telehealth 52

Telehealth Healthcare Hospitals Patient Safety 52

Relias

JUNE 19, 2023

Since 2016, fewer patients with severe wounds have received care in long-term care hospitals, and more patients have gone to less costly facilities like inpatient rehabilitation and skilled nursing facilities. billion in fiscal year 2016 to $2.01 billion in fiscal year 2018. “The

Healthcare 52

Healthcare Rehabilitation Medicare Hospitals 52

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.

Nursing Home 52

Nursing Home Healthcare Hospice Medicare 52

Relias

APRIL 6, 2022

New requirements from the Centers for Medicare and Medicaid Services (CMS) announced in November 2021 and a new time-limited enforcement effort by the Occupational Safety and Health Administration (OSHA) announced in March call for focused inspections and put a higher level of scrutiny on nursing home compliance and the quality of care provided.

Nursing Home 52

Nursing Home Medicare Medicaid Hospitals 52

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. The new measures included the Birthing-Friendly hospital designation to help reduce maternal mortality and morbidity.

Hospitals 40

Hospitals Medicaid Mental Health Medicare 40

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

Medicare 10

Medicare Clinic Medicaid Hospitals 10

Relias

FEBRUARY 1, 2023

Claim denials cause revenue loss at a time when hospitals are facing a serious financial crisis. That leaves hospitals and medical practices to try to get all the denials overturned. Some Medicare Advantage plans are denying authorization for hospitalization. We communicate the change to the pharmacy team.

Healthcare 10

Healthcare Hospitals Medicare Clinic 10