The Interoperability Imperative

The Interoperability Imperative

  • September 19, 2016

How interoperability unlocks silos in enterprise applications and connects the business logic needed to support value-based reimbursement By Michael Wood Interoperability is about more than just moving data from one application to another. It’s about easily and seamlessly capitalizing on the business logic that is locked within separate—and often siloed—applications to create new capabilities that can solve business problems in a unique way. Today, interoperability must occur both within the four walls of a payer or provider’s IT infrastructure as well as within or between on-premise, off-premise, cloud, hybrid, and other hosting approaches in a manner that appears to be…

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Short-Stay Inpatient Rate Is Zero? Time For Documentation Improvement

Short-Stay Inpatient Rate is Zero? Time for Documentation Improvement

  • May 11, 2016

Hospitals will need to reevaluate their documentation improvement programs because of revisions to the two-midnight rule, which allow for a case by case review of less-than-two-midnight stays. The quality improvement organizations have stated that the review will include InterQual screening criteria. Read the article

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The Two-Midnight Rule: Changes For 2016

The Two-Midnight Rule: Changes for 2016

  • February 1, 2016

Medical Necessity Documentation Still Required Have you heard the news? In the 2016 Outpatient Prospective Payment System Final Rule the Centers for Medicare & Medicaid Services (CMS) has modified the two-midnight rule evaluation and enforcement process. The “probe and educate” period ends on January 1, 2016. Enforcement of the rule will be the responsibility of the two BFCC Quality Improvement Organizations (Livanta and KEPRO). Their charge is to evaluate the appropriateness of short-stay inpatient admissions that extend over less than two midnights. Both BFCC Quality Improvement Organizations (BFCC-QIOs) will use InterQual as a decision support tool to help evaluate whether…

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