Posts Tagged CMS

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What is a Medical Home?

© Maigi | Dreamstime.comThe Medical Home, also called the Patient-Centered Medical Home, and the Personal Medical Home, is a movement to solve the problem of fragmented care (one hand doesn’t know what the other is doing) by having a primary care physician or practitioner act as the center of all care information for the patient.   Fragmented care is dangerous (lack of coordination of care causes mistakes and mistreatments), costly (repetition of diagnostic tests and regimens), and wasteful of healthcare resources.  The Medical Home plan goals are to provide care for all individuals, improve care, and decrease healthcare costs.

Crossing the Quality Chasm: A New Health System for the 21st Century” was published in 2001 by the Institute of Medicine.  In this landmark book, the patient’s role and responsibility for navigating the healthcare system and acting as the information hub around which the spokes of primary, specialty and tertiary care providers revolve was denounced (more…)

Posted in: Day-to-Day Operations, Medicare & Reimbursement, Memes

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What Health Care Providers Need To Know About Medicare and the RAC

Carla Hannibal

By Carla Hannibal, CMM,CPM,CIMBS

Recovery Audit Contractors (RACs) will pursue corrections of Medicare claims by auditing for overpayments and underpayments under Part A or B of the title XVIII of the Social Security Act.  Health care providers will be affected as Medicare has recently contracted with RACs for 2009 and beyond.  RACs will audit every United States and Peurto Rico health care provider who files with Medicare.  The audit and recovery plan is expected to be in place by (more…)

Posted in: Headlines, Medicare & Reimbursement

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