The Compliance Corner: Opt-Out, an Alternative Workers' Compensation Model
Opt-out in the workers’ compensation world is 2016’s buzzword for deregulation of payment for workers’ compensation claims at the state level. Opt-out is an alternate compensation model for the injured worker whereby employers choose to opt-out of state regulated systems. It has been promoted in some states like Oklahoma and Texas.
The Compliance Corner: Telemedicine: New Innovations in the Old Program
Telemedicine is the method of delivering health care electronically through applications like smart phones, email, and skype. Telemedicine started over 40 years ago with the intention of enabling health care providers, mainly hospitals, to provide services to patients in remote areas.
The Compliance Corner: Understanding MACRA in the P&C Industry: Medicare Access and CHIP Reauthorization Act of 2015
A change is in the wind, or more like a tornado, when it comes to new healthcare reforms, particularly on the payment side. In 2019, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will be introduced requiring new quality measurements.
The Compliance Corner: Using Subluxation Codes vs. Dislocation Codes
Before implementation of ICD-10-CM, during the archaic times of ICD-9-CM (was it really only 16 months ago?!), chiropractic physicians typically reported diagnosis codes from the 739 series of “non-allopathic lesions” which included “segmental and somatic dysfunction.”
The Compliance Corner: What Lies Ahead for Medical Marijuana Insurance Coverage?
Prescription protocols for medical marijuana are changing monthly due to new studies promoting use and regulatory bodies that allow the prescription of medical marijuana in their states. Medical marijuana, sometimes referred to as “Medical Jane,” has been used for medical purposes since 1550 BC in ancient Egypt to treat inflammation.
Prepare for IAIABC Claims Release 3.1 by Starting with Your EDI Reporting Process
The IAIABC (International Association of Industrial Accident Boards and Commissions) maintains and develops electronic reporting standards in the Workers Compensation arena. Since 2003, the IAIABC Claims Release 3.0 has been in publication.
The Compliance Corner: New Physical Therapy Evaluation Codes for 2017: Moving Toward Value Based Payment
The American Medical Association (AMA) shook up the Property and Casualty industry by bringing a big change to the 2017 Current Procedural Terminology (CPT) code set. Two very familiar CPT codes, 97001 Physical Therapy (PT) Evaluation and 97002 Physical Therapy Re-evaluation were deleted effective January 1, 2017.