ED Coding & Reimbursement Alert - 2015 Issue 31
Physician Notes: Observation Care Will Require Notice to Patients
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Article Overview
This article summarizes a Medicare-related patient-notification law affecting observation care, a hospital’s response to an employee patient-record access violation, and a billing integrity issue reported by a Part B Medicare contractor. It is relevant to hospital billing staff, compliance teams, coders, and revenue cycle professionals who track regulatory updates and common claim-denial causes.
Why This Topic Matters
It highlights operational changes that can affect patient communication, post-discharge coverage awareness, privacy compliance, and claim acceptance. The article is useful for organizations that bill Medicare, manage observation services, or oversee HIPAA compliance and front-end claim accuracy.
What You Will Learn
- The purpose and scope of a new patient notice requirement tied to observation care.
- How a hospital responded to unauthorized access of patient records and the compliance implications involved.
- Why Medicare claims may be denied when beneficiary identification information does not match.
- Which operational areas of hospital billing and compliance are affected by these updates.
Who Should Read This
- Hospital billing departments
- Revenue cycle staff
- Compliance officers
- Health information management professionals
- Medical coders
- Practice managers
- Medicare billing staff
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