Pertinent information to help providers continue to give the care your patients need
- The COVID-19 Coronavirus resource center contains critical updates and education to help providers stay informed and mitigate business disruptions caused by threats, such as revenue shortages and staff reductions.
- Information on this health care portal includes – CMS protocols, health care education courses, briefs, expert webinars, reference guides, health information management products, revenue cycle management solutions and staffing solutions to combat shortages at your hospital or health care organization.
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Multiple Program Updates
NEW12/01/2020
Given the pandemic continues, multiple program updates impacting price transparency, cost sharing waivers, Modifier CR, Condition codes DR and 90, reimbursement increases for testing, and regulations for "Acute Hospital Care at Home" have been summarized in this single document.
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Vaccine and Therapeutic Updates
NEW12/01/2020
To ensure broad and consistent coverage across programs and payers, CMS created toolkits that have specific information for several programs, including coverage of Covid-19 Coronavirus vaccines and other therapeutics.
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Telehealth Expansion
10/21/2020
CMS published additional temporary emergency rules to further expand telehealth including over 135 allowed services and new qualified providers including but not limited to therapists, licensed clinical social workers, and clinical psychologists.
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Diagnostic Testing
09/15/2020
A new CPT code created by AMA and diagnostic testing requirements.
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Hospital Infection Control Data Reporting
09/15/2020
The Interim Final Rule (IFR) released on August 25, 2020 outlines criteria for submitting infection control data for hospitals including CAHs and LTCF.
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Re-opening Medical Practices
09/15/2020
Guidelines for reopening medical practices were released including the reporting of new CPT code 99072.
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Financial Guidance
08/27/2020
CMS has granted several financial updates including but not limited to Accelerated/Advance payments and updates to Merit-based Incentive Payment System (MIPS).
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Laboratory Data Reporting
08/27/2020
New data reporting guidelines for hospitals performing diagnostic testing.
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Inpatient Hospital Care Update
08/24/2020
CMS released an updated ICD-10 MS-DRG GROUPER software package allowing a 20% increase to the DRG rate to accommodate the new ICD-10-CM diagnosis code U07.1 effective with discharges on and after April 1, 2020.
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Self-Isolation Counseling
08/10/2020
Guidelines for reporting counseling about the importance of self-isolation after they are tested and prior to the onset of symptoms.
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Telehealth Skilled Nursing
08/10/2020
Clarification of approved telehealth visits for Skilled Nursing patients using audio-only telephone calls reported with 99441-99443.
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Modifier CS Cost-Sharing Coding Update
07/09/2020
CMS released guidelines for reporting Modifier CS to identify claims where cost-sharing is being waived in relation to the COVID-19 emergency.
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RHC and FQHC Payment Update
07/09/2020
Summary of payment and reporting guidelines for telehealth claim submission by RHC and FQHC distant site providers.
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Telemedicine Hospital Outpatient Billing
06/25/2020
New regulation from CMS for billing hospital outpatient provider-based department (HOPD) services using communication technology-based services (CTBS) similar to or the same as used for telehealth.
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Laboratory Waiver Update
06/19/2020
New laboratory waivers released on March 30, 2020 provide flexibility with CLIA guidance, specimen collection and data collection from hospitals.
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Condition Code DR and Modifier CR Update
06/03/2020
Clarification of guidelines for reporting Condition code DR, Disaster Related, and Modifier CR, Catastrophe/disaster related.
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Telehealth RHC/FQHC Billing
05/06/2020
New regulation including more definitive guidelines on how Rural Health Clinics (RHC) and Federally Qualified Health Clinics (FQHC) are to report and be reimbursed for telehealth services.
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Provider Relief Fund
04/29/2020
Summary of the relief fund process and payments distributed to hospitals and other health care providers.
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Re-opening Health Care
04/23/2020
Summary guidelines released by the White House for Opening Up America Again, using a three-phased approach based on the advice of public health experts.
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Convalescent Plasma
04/22/2020
Review of the national Expanded Access Program (EAP) designed to collect and provide convalescent plasma with antibodies from recovered COVID-19 patients to patients in need across the country.
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FCC Telehealth Program
04/16/2020
New guidance on actions applicants can take to prepare for filing an application for COVID19 Telehealth Program funding.
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Commercial Cost Sharing
04/14/2020
New guidance to ensure Americans with private health insurance have coverage of COVID-19 diagnostic testing and certain other related services, including antibody testing, at no cost.
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CARES Act Waivers Part II
04/08/2020
The CARES Act includes other key provisions related to hospitals and health systems not otherwise covered in the specific coding updates.
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CARES Act Waivers
04/02/2020
New waivers released by CMS on March 30, 2020 introduce new flexibilities and expand previous waivers published.
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ICD-10-CM Diagnosis Coding
04/02/2020
CDC action changing the effective date of new diagnosis code U07.1, COVID-19, from October 1 to April 1, 2020.
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Utilization Review/Case Management Updates
04/02/2020
New waivers released by CMS provide flexibility with utilization review and case management requirements including but not limited to discharge planning, 3-day SNF stays and advanced directives.
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Compliance Topics
04/01/2020
CMS has released waivers that address topics that otherwise might be considered compliance issues such as EMTALA, verbal orders, Stark Law, etc.
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Interim CDC Recommendations for Inpatient OB Care
03/27/2020
The Center for Disease Control (CDC) has published infection control recommendations for inpatient hospital providers to consider in providing obstetric (OB) services.
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Medicare Beneficiary Notice Delivery Guidance
03/27/2020
CMS released an MLN Connects bulletin that includes guidance for delivery of beneficiary notices to patients who may have COVID-19.
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State Medicaid Waivers and Telehealth
03/27/2020
Guidance on state Medicaid waivers published, including available telehealth flexibility.
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Implementing Virtual and Telehealth Services
03/23/2020
Guidance on implementing virtual and telehealth services including two comprehensive toolkits.
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Medicare Provider Enrollment Relief
03/23/2020
Summary of enrollment relief to help hospitals onboard additional Medicare eligible providers.
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Quality Reporting Waiver
03/23/2020
Summary of exceptions granted for reporting requirements and extensions for providers participating in Medicare quality reporting programs.
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Telehealth HIPAA Waiver Update
03/20/2020
A bulletin released by HHS allowing covered health care providers to use popular applications for video chats.
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Diagnostic Testing Coverage
03/19/2020
Steps that patients must take to obtain a test, including a physician order.
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Medicare Waivers
03/17/2020
Waivers issued by CMS to prevent gaps in access to care for beneficiaries impacted by the emergency.
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COVID-19 Continues: Reopening Health Care During the Public Health Emergency
07/24/2020
Keeping up with COVID-19 – July 16, 2020, 1 pm ET: With COVID-19 part of the continued public health landscape, hospitals will need to identify how to best meet the health care needs of infectious patients while continuing to provide diagnostic treatment and care to the public at large. This presentation explores the measures that can be implemented as part of responsibly re-opening non-emergent health care services and the data necessary to self-regulate the provision of these services and defend against a potential second push from state or federal regulators to limit hospital services as occurred in the pre- and early pandemic period.
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Leveraging Education as a Key Strategy of a Solid Business Continuity Plan
07/14/2020
Keeping up with COVID-19 – July 9, 2020, 1 pm ET: COVID-19 has taught the health care industry the importance of business continuity and recovery planning in order to maintain productivity during business disruptions. Quickly placing colleague resources where they are needed most and avoiding furloughs or layoffs in other areas, is essential for this. Organizations can provide colleagues training and an ongoing path for skill enhancement and growth that fosters increased quality of patient care and satisfaction. We will share strategies for developing a cross-training program that fosters an increased quality of patient care and satisfaction, as well.
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Provider Life During and Post-COVID-19
07/09/2020
Keeping up with COVID-19 – June 11, 2020, 1 pm ET: Our world has changed forever since February when the first cases of COVID-19 were diagnosed in the northwest. This is especially true for the health care industry, from first responders and health care professionals working the front line to administrators trying to keep their doors open in more ways than one. Join our panel discussion with health care executives as they discuss their organizations' COVID-19 experiences from preparation to survival.
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Applied Lean Six Sigma Methodology Can Help Hospitals Thrive Beyond COVID-19
07/07/2020
Keeping up with COVID-19 – June 18, 2020, 1 pm ET: At all levels of health care leadership and practice, people who are trained in key Lean principles are better prepared to help transform their practices during a time of crisis when agility and optimization are mission critical. This session reviewed a case study where nThrive has synthesized lean methodology and industry knowledge to better operationalize our hospitals. We also highlighted the trends of US health care in a "post-COVID-19" world, covering how Lean methodology will continue to be utilized in the accelerating shift towards value-based care.
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Securing Revenue for Hospitals and Providers in a COVID-19 Environment
06/18/2020
Keeping up with COVID-19 – June 4, 2020, 1 pm ET: Ongoing changes to federal and state regulations are causing many hospitals to struggle with understanding how to bill claims for COVID-19 patients, and what data analysis will help ensure that all providers secure the reimbursement available. This presentation addressed the regulatory requirements for reporting COVID-19 claims and the proactive analysis to conduct to help providers secure revenue during this challenging time. We also addressed next steps for you to consider as the journey to normalcy continues.
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Business Continuity and Recovery for COVID-19 and Beyond
06/10/2020
Keeping up with COVID-19 – May 21, 2020, 1 pm ET: COVID-19 quickly tested the Business Continuity Plans of healthcare organizations. How did your organization measure up? Are you prepared for an anticipated increase in volumes? Or the predicted second wave that might disrupt operations later this year? During this session, attendees learned how pre-planning for Business Continuity and Business Recovery during a pandemic or other disruption of service is key to ensuring ongoing success and viability of operations, understood where and when to leverage technology, and learn strategies for augmenting resources when valued team members are unable to work.
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How Robotic Process Automation Can Improve Revenue Cycle Efficiency During COVID-19 Recovery
05/19/2020
Keeping up with COVID-19 – May 14, 2020, 1 pm ET: During the COVID-19 crisis, health care organizations have been challenged to dramatically change many of their revenue cycle management processes, respond to volume shifts in elective surgeries and routine Emergency Room (ER) cases, and adjust staffing to compensate. This session highlighted how organizations will respond to a high volume of rescheduled procedures, potentially lower productivity, and higher volume leading to a spike in AR days as America reopens.
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COVID-19 Pandemic Accelerates the U.S. Transition to Value-Based Care
05/12/2020
Keeping up with COVID-19 – May 7, 2020, 1 pm ET: The novel coronavirus has forced U.S. healthcare to rapidly embrace low-cost alternatives to traditional in-patient and in-person care. This session highlighted the impact of COVID-19 on the current Revenue Cycle as well as explore factors that will shape imminently revised standards of care.
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Leverage Physician Analytics During COVID-19 and Beyond
05/04/2020
April 30, 2020, 1 pm ET: This webinar, presented in partnership with MGMA, discusses how to leverage analytics during the COVID-19 crisis. It addresses physician productivity in the “new normal,” especially for organizations with an integrated delivery model. Also, how yesterday’s benchmarks are being redefined and how organizations can level-set to improve workflows and profitability, building a data-driven playbook for sustainable improvement during COVID-19 and beyond.
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Journey to Virtualization in the Health Care Revenue Cycle
04/24/2020
Keeping up with COVID-19 – April 23, 2020: The COVID-19 Coronavirus pandemic has prompted providers to implement remote working environments – a significant in many key business practices. This webinar addressed how to reimagine the workplace by implementing frameworks, manage virtual teams, tackle technological barriers, ensure smooth infrastructure changes and navigate new landscapes for managing patient payment information.
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The CARES Act Impact on Health Care Funding and Programs
04/16/2020
Keeping up with COVID-19 – April 16, 2020: This webinar identified the opportunities in federal funding for eligible health care entities under the CARES Act and explains how to take advantage of the $100 billion in reimbursements for eligible health care providers. It addressed the types of diagnostic and other activities that can be used for the additional $27 billion funds, and how workforce modernization and telehealth are funded.
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Revenue Enhancement Through Patient Care Improvement During and After the Public Health Emergency
04/09/2020
Keeping up with COVID-19 – April 9, 2020: This webinar addressed the Centers for Medicare & Medicaid Services’ (CMS) recent move to relax restrictions and waive certain telehealth requirements that previously limited the expansion of telehealth technology in the delivery of health care. This waiver was issued in order to reduce the spread of COVID-19 Coronavirus while allowing vulnerable patients to continue receiving routine and screening care.
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Business Continuity and Recovery Solutions for COVID-19 Coronavirus
nThrive offers business continuity solutions to fill current staffing shortages, transition colleagues to critical role and preserve cash and accounts receivables. Our business recovery solutions identify and recover cash as well as scaling critical revenue cycle operations to return to normal.
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Three Keys to a Top-Notch Virtual Work Environment – for COVID-19 and Beyond
05/08/2020
Virtualization in health care is accelerating as a result of COVID-19, from telehealth to business operations. Read a recap of our "Keeping up with COVID-19" virtualization webinar to learn more.
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"Keeping up with COVID-19" Webinar Recap: Understanding CARES Funding and Programs
05/07/2020
Although complicated, it behooves health care organizations to understand and comply with CARES Act requirements. Read our recap of the "Keeping up with COVID-19" CARES Act webinar to learn more.
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"Keeping up with COVID" Webinar Recap: Leveraging Telehealth Now and Beyond
05/06/2020
Based on legislative changes, telehealth can be leveraged anywhere in the country to provide impactful patient solutions during times of social distancing. Read our nThrive Webinar recap on the waivers or watch the Webinar-on-Demand (WOD) here to learn about the benefits of telehealth for patient care and physician safety during the COVID-19 Coronavirus pandemic.
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Access CARES Act Provider Relief Funds Today
05/06/2020
Beginning May 6, 2020 providers can begin the qualification process to receive COVID-19 claims reimbursement for uninsured patients. If providers aren’t able to complete the required steps in a timely and efficient manner, they run the risk of delayed or missed reimbursement. Read more to learn how to begin accessing CARES Act Provider Relief Funds today.
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nThrive, Banner and Moffitt Cancer Center Explore Robotic Process Automation
Software "bots" can automate some repetitive functions in the health care revenue cycle, freeing staff for higher value tasks. Read our blog on how automation can reduce costs and increase efficiency at your medical organization.
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Value-based Care Analytics: Leveraging Data Insights to Enhance Reimbursement and Quality
In today’s value-driven reality, government legislation such as the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) is shaping the course with new value-based reimbursement (VBR) payment models, linking quality performance metrics to provider reimbursement. Health care organizations are under immense pressure to adapt to VBR and quality-based incentive models to replace fee-for-service models.
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Telemedicine Outpatient Hospital Billing Decision Tree
06/19/2020
Quick reference guide summarizes telemedicine reporting for hospitals.
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COVID-19 Coronavirus Diagnostic Testing
05/29/2020
Quick reference guide summarizes laboratory testing and diagnostic coding guidelines.
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Telehealth Documentation and Consent
05/06/2020
Quick reference guide summarizes the documentation requirements for Telehealth visits, Virtual check-ins and E-visits.
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Telehealth Professional Coding
05/06/2020
Quick reference guide summarizes professional coding and billing requirements for health care providers on a 1500 claim.
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Accelerated Payments
04/29/2020
Quick reference guide summarizes Accelerated / Advance payments including eligible providers and repayment terms.
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Product Enhancement Quick Reference
Document summarizes provider support available and scheduled product updates to support health care organizations throughout the pandemic and beyond.
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Coding for Telemedicine
04/22/2020
This webinar provides an overview of telemedicine, including the types of services, a review of the Medicare Telemedicine Health Care Provider Fact Sheet and CPT and HCPCS coding.
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COVID-19 Coronavirus Free Courses
04/15/2020
Access COVID-19 Coronavirus courses for health care colleagues at no cost, hosted by our education partner, HealthStream.
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COVID-19 Coronavirus and nThrive Business Continuity Plans
05/07/2020
nThrive enacted its business continuity plan on February 28, 2020, in anticipation of our need to make colleague safety, business continuity, and extending additional support to clients our top three priorities.
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COVID-19 Uninsured Coverage Verification
05/05/2020
Steps to ensure your organization receives funding from the HRSA COVID-19 Uninsured Program.
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Business Continuity and Recovery Solutions for COVID-19 Coronavirus
nThrive offers business continuity solutions to fill current staffing shortages, transition colleagues to critical role and preserve cash and accounts receivables. Our business recovery solutions identify and recover cash as well as scaling critical revenue cycle operations to return to normal business operations.
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COVID-19 Coronavirus and nThrive Protocols
The nThrive approach is to align with the CDC recommendations, as well as recommendations from other Government agencies in the US and India, to help ensure that our colleagues and their families stay safe and healthy. nThrive is continuing to monitor the situation and will provide updates as needed.
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Financial Viability Preservation for Health Care Providers
Steps to ensure your organization continues to serve its community.
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Product Enhancement Quick Reference
Reference guide summarizes product updates, progress and timing as nThrive enhances technology that tackle issues caused by COVID-19 Coronavirus pandemic.
Disclaimer. The information on this site (the “Content”) is intended for educational and reference purposes only. nThrive strives to provide accurate information in the Content, but assumes no responsibility or liability for any errors or inaccuracies that may appear. nThrive makes no warranty, express or implied, regarding the accuracy, adequacy, completeness, legality, reliability, or usefulness of any Content provided and specifically disclaims any implied warranties of merchantability or fitness for a particular purpose. All Content is provided on an “as-is” basis. While the Content may reference materials or content from other third parties such as the Center for Medicare and Medicaid Services (“CMS”), the information provided does not necessarily reflect opinions, policies, and/or official positions of CMS or any other third party. The Content is not meant to be a substitute for any medical, financial, legal or other professional advice and users are advised to use their own clinical judgment and/or seek professional assistance where appropriate.