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

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

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 Medicare Healthcare 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 Medicare Healthcare 52

Social Work Blog

DECEMBER 20, 2021

Implications for Clinical Social Workers. On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the CY 2022 Medicare Physician Fee Schedule (PFS) final rule. The 2400+-page rule includes updates to policies and payments that are pertinent to clinical social workers (CSWs) and other Medicare providers.

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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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Psychotherapy Medicare Social Worker Nursing Home 98

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.

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Healthcare Medicare Medicaid Psychiatric 52

Relias

OCTOBER 25, 2021

Taking advantage of the changed rules will allow home health agencies to more efficiently use the first visit, which has positive implications for clinical outcomes and the agency’s bottom line, observed Karen Vance, BSOT, discussing the CoP update in a recent Relias webinar.

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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.

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Healthcare Medicare Medicaid Substance Abuse 52

Center for Child Protection

JUNE 26, 2024

These series allow our clinical staff, who have intimate knowledge of our clients’ needs, to ask specific questions and obtain detailed information that a generic resource list cannot provide. Nicole Curcio , LCSW, Lead Family Advocate Feedback from our clinical staff has been overwhelmingly positive.

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Domestic Violence Community Outreach Confidentiality Advocacy 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. The NTA scores are based on a point system, and additional points are given to patients based on the clinical complications of their conditions. Build clinical excellence.

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Medicare Clinic Medicaid Hospitals 10

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 Clinic Hospitals Medicaid 52

Relias

APRIL 18, 2025

James Merlino, Chief Clinical Transformation Officer at Cleveland Clinic In todays competitive healthcare landscape, this healthcare patient experience quote highlights that focusing on patient experience is essential for organizational success. Improving the patient experience is not just a nicety.

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Healthcare Empathy Medicare Medicaid 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% CMS expected PDGM to drive changes in clinical group coding, comorbidity coding, and low utilization payment adjustment (LUPA) threshold. All-Payer Policy for Home Health Quality Reporting.

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Medicare Telehealth Hospice Medicaid 52

Relias

JANUARY 11, 2023

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. By 2005, the Centers for Medicare and Medicaid Services (CMS) began piloting value-based care programs that linked payment to quality measures.

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Medicare Healthcare Medicaid Hospitals 52

Relias

JANUARY 8, 2024

The relationship between patient satisfaction scores, reimbursement, and health outcomes The Centers for Medicare and Medicaid Services’ (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring helps hospitals and governing bodies evaluate patient satisfaction through quantitative measurements. In 2019, $1.9

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Healthcare Medicare Hospitals Clinic 52

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 following provides key takeaways for clinical social workers: Telehealth. Behavioral Health.

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Medicare Telehealth Clinic Mental Health 40

Relias

MARCH 1, 2023

Short video-based courses that provide a refresher on the assessment and clinical skills necessary to prevent avoidable hospitalization can be helpful. She encouraged hospital providers to increase the amount to 80%-90%. Training plays a significant role here.

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Hospitals Medicare Nursing Home Medicaid 52

Relias

MARCH 12, 2025

For example, the Centers for Medicare and Medicaid Services (CMS) mandate facility assessments in long-term care facilities to ensure that staff competencies align with the needs of the patient population. Rather than just testing knowledge, these evaluations measure how well employees apply their skills in a clinical setting.

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Patient Safety Healthcare Medicare Clinic 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 Clinic Patient Safety 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 Clinic 52

Relias

JUNE 28, 2023

This means considering things like: Referring working patients to clinics that offer extended hours Referring Medicaid patients to well-known psychiatric units that work well with their insurance And more Building rapport and understanding the patient more fully can help PCPs direct patients to the appropriate resource and encourage follow-ups.

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Healthcare Mental Health Psychiatric Psychosocial 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. The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023.

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Medicare Hospice Healthcare Medicaid 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.

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Home Care Healthcare Hospice Medicare 52

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 Medicare Communication 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 Psychotherapy 98

Child Welfare Monitor

JULY 22, 2024

.” It does not define RTF’s, but the term clearly refers to facilities that provide behavioral health services in a residential context to children with funding from programs under SFC jurisdiction, mainly Medicaid and foster care funds under Title IV-E of the Social Security Act.

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Foster Care Interventional Child Welfare Medicaid 154

Shelter, Inc

OCTOBER 17, 2024

With recognition from grantors on our work, we were thrilled to receive the first community impact grant from Endeavor Health and a $273,000 behavioral health initiative grant from Cook County to expand our clinical department. The expansion of this program will provide essential services to children and families in underserved Cook County.

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Child Welfare Welfare Foster Care Medicaid 59

Bipolar Bandit

SEPTEMBER 3, 2021

I increasingly realized that there is no opportunity to influence legislators to change the system in the clinical setting. I wrote Breakdown to appeal for legislative reform because it’s nearly impossible to change the system from within the trenches of clinical work.

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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 Medicare 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

NOVEMBER 9, 2023

of citizens identifying as American Indian or Alaska Native relied on Medicaid or other public health insurance, and 14.9% on Medicaid or public health insurance and only 6.3% Insufficient funding creates a lack of clinical resources because available funding is often put toward direct patient care. had no coverage at all.

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Healthcare Telehealth Medicaid Clinic 59

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 Hospice 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

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

JULY 14, 2022

Hospitals and health systems have targeted their approaches to these issues and others to help reduce complications through adherence to evidence-based clinical protocols and reducing variation in care. One area of increasing focus that hasn’t received as much attention is the intersection of maternal mortality and maternal mental health.

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Mental Health Patient Safety Healthcare Domestic Violence 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.

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