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Telemedicine Faces Unprecedented Demand in Wake of Coronavirus Crisis Print E-mail
Written by Amrita Khalid | QUARTZ   
Tuesday, 24 March 2020 16:53

Telehealth services are being met with a flood of patients in the wake of the coronavirus pandemic. As hospitals and public officials urge patients with symptoms of COVID-19 to avoid emergency rooms, online-only services that allow patients to consult with doctors over the phone, video, or direct message are a natural fit. But as demand increases, telehealth providers will confront two challenges: capacity and access. For those with private insurance, many providers have said that telehealth screenings for COVID-19 will be covered for free under their plans. And on Tuesday, President Donald Trump authorized an expansion of Medicare that would cover telehealth, allowing the elderly access to care without leaving their homes. But states have been left to decide on their own whether to expand Medicaid to include telehealth services. Which means that many who are low-income or uninsured may have no choice but to pay out-of-pocket for these services.

In-Home Care Versus Adult Day Care Print E-mail
Written by AHHC News   
Wednesday, 11 March 2020 16:51

When people reach old age, their lives often change in significant ways. Many people will retire once they’ve reached old age, giving up their career after years of hard work. This gives them a lot of free time they didn’t have before. Some people may give up their driving privileges because of vision concerns and other issues. By doing this, seniors lose some freedom; but often it is best for their safety. Many elderly individuals will require some form of care to help them go about their everyday lives. When it comes to care, what is best for your patient or elderly loved one depends on their unique care needs and preferences. Although they are both care services, there are big differences between adult day care and home care services, making it important to understand what each option offers.

What’s In-Home Care?
In-home care is a service where a caregiver provides assistance to an elderly individual at their own home. The caregiver will go to the senior’s home and help with various tasks, such as personal hygiene, chores and cooking. In-home care can also include the caregiver running errands for the client or providing them with transportation to wherever they need to go. This service can be provided on a full-time basis, a part-time basis, or for a temporary time period.

What's Adult Day Care?
Adult day care is a service that provides seniors with activities to occupy their time and provide them with social interaction and mental stimulation. Usually, adult day care will include simple meals and snacks. It’s important to note that adult day care doesn’t include health-related services and is often only available during the daytime.

What Are the Benefits of In-Home Care?
One of the biggest benefits of in-home care is that it allows seniors to remain in the comfortable, familiar place that is their home. This can be especially important for seniors who have Alzheimer’s disease or dementia, because that comfort they have can make a world of difference for them. In-home care services are also very customizable and flexible, so they can be tailored to meet the senior’s specific needs and can  be altered to accommodate any changes. If your elderly loved one only needs help on a part-time basis with just a couple of tasks, such as cleaning and errands, then in-home care services can meet those needs. If your elderly relative needs help on a 24/7 basis, then there are in-home care services that ensure your loved one has an alert, awake caregiver at all times. If a senior recently had surgery and needs help at home until they fully recover, then in-home care services can be customized to help them make the transition back home. A less recognized perk of in-home care is the companionship that a caregiver provides. When a caregiver is assigned to a client, they take the time to get to know and bond with the senior they’re helping. When you choose in-home care, your elderly loved ones will get a new friend who will provide them with personal, compassionate care.

What are the Benefits of Adult Day Care?
Just as movement and exercise are important for your body, it’s important to give your brain a workout as well, especially for seniors. At adult day care, seniors can get mental stimulation by partaking in fun activities and socializing with other elderly individuals. It also provides a different environment from their home where they will still get supervision.

Which One Is Better?
Whether in-home care or adult day care is better for your patient or elderly relative depends on their needs and preferences. In-home care services are an accommodating option that covers a wide variety of things and your loved ones can receive home care any time of the day. With in-home care, caregivers will provide seniors with as much or as little care as they need. There are also so many types of home care services: senior home care, live-in care, overnight care, and Alzheimer’s and dementia care among others. On the other hand, if your patient or elderly loved one simply needs some supervision and activities to fill their time, then adult day care can be suitable for them.
Assisting Hands Home Care is based in Kendall and serves all of Miami-Dade. Learn more at

Last Updated on Wednesday, 11 March 2020 17:36
Doctors go back to school to learn the business of medicine Print E-mail
Written by FHI's Week in Review   
Monday, 09 March 2020 18:10

Joanne Finnegan contributes an excellent article, for Fierce Healthcare on March 5, featuring various physicians who have returned to school for an MBA. Most doctors would rather not have to worry about the business of running a healthcare organization and would prefer to focus on taking care of patients, says Aaron Hattaway, MD, a Florida radiologist, who is a current student in the physician MBA program and expects to graduate in May. But in today's world, "you better learn it," he advises. "It's what runs the world."

Read more in the current issue of Week in Review>>

Last Updated on Wednesday, 15 April 2020 09:35
FIU Nursing Names Dr. Ellen Brown as the Wallace Gilroy Endowed Faculty Scholar for Her Research on Elderly Care and Caregiver Support Print E-mail
Written by FHInews   
Friday, 06 March 2020 12:33

MIAMI (March 5, 2020) –Ellen Brown, E.d.D., F.A.A.N., an associate professor of graduate nursing at Florida International University’s (FIU) Nicole Wertheim College of Nursing & Health Sciences, has been named as the Wallace Gilroy Endowed Faculty Scholar. The two-year appointment, made possible through the Wallace Gilroy Endowed Nursing Research Fund established by the Hugoton Foundation and Joan K. Stout, R.N, will promote her research specializing on caregiving in the aging population.

The appointment will further Dr. Brown’s current collaboration with Miami Jewish Health to evaluate the impact of empathy in health care delivery for older adults, many living with dementia. For the past two years, Dr. Brown has been working with Marc E. Agronin, M.D., Senior Vice President, Behavioral Health and Chief Medical Officer for Miami Jewish Health’s MIND Institute, to pilot Miami Jewish EmpathiCare.

The comparative study will evaluate patient outcomes and clinical practice for approximately 80 of Miami Jewish Health’s nursing staff who receive empathy-based training to those without such training in caring for the facility’s residents. Findings could help establish baseline competency levels for nursing professionals in this patient specialty and hiring standards for health settings dealing with dementia patients, such as long-term care, assisted living and hospice care facilities.

“Dr. Brown’s dedication to improve the health and well-being for this highly vulnerable patient population, and for the people who care for them, is unmatched, making her the perfect recipient for this faculty honor,” said Ora L. Strickland, Ph.D., F.A.A.N., dean of the college. “She has spent three decades working on valuable research and creating practical solutions to empower practitioners and lay caregivers with the proper resources to deliver the highest quality care to the elderly and prepare themselves for the mental and physical demands of doing so.”

Dr. Brown was also instrumental in developing the CareHeroes web and smartphone app.  The app is designed to improve dementia care coordination between practitioner and family caregiver two-fold: (1) through a secure platform for sharing clinical information in real time with greater accuracy, and (2) access to multi-media educational content on Alzheimer’s Disease-Related Dementias (ADRD) and caregiving including with the CareHeroes chatbot. The CareHeroes app also serves as a stand-alone intervention to reduce the negative impact of caregiving on the family caregiver by linking them to services and resources that caregivers often are unaware exist, and addresses mental health needs of caregivers through self-screens for depression and burden that provide instant feedback and recommendations.

Dr. Brown and fellow lead investigator Nicole Ruggiano, an associate professor of social work at the University of Alabama, are currently conducting a study funded by the Agency for Healthcare Research and Quality to evaluate the impact of practitioners’ and caregivers’ use of the CareHeroes app on clinical workflow and decision-making with patients at Miami Jewish Health’s The MIND Institute and the University of Alabama-Birmingham Memory Clinic.

Dr. Ellen Brown is cultivating the future landscape of elder care with her nationally recognized research in gerontological nursing. She has received funding from the National Institute of Mental Health and Florida Department of Health, among others, for her work in the areas of geriatric depression care, caregiver education, and service delivery. The nursing intervention developed by Dr. Brown and colleagues, “Training in the Assessment of Depression,” received national recognition in 2011 by the American Academy of Nursing’s Raise the Voice: Edge Runner program. She is a Fellow of the American Academy of Nursing and founding editorial board member of the Research in Gerontological Nursing journal. 
Modifier 25 Requirements for Avoiding Potential Billing Fraud Print E-mail
Written by Dave Davidson | Florida Healthcare Law Firm   
Tuesday, 03 March 2020 10:07

On February 4, 2020, the Department of Justice announced a $1.5 million settlement with Southeastern Retina Associates, a 17 physician practice, with offices in Tennessee, Georgia and Virginia.  The sole basis of the claim was the alleged misuse of the Modifier 25 billing code and charging for exams at higher levels than warranted.  The claim was initiated by a whistleblower, who will receive $270,000 from the settlement.

Use and potential abuse of Modifier 25 is obviously not unique to retina surgeons.  In fact, the modifier can be very beneficial to providers, since it allows for payment for those patient visits when the care provided exceeds the scope of the scheduled appointment.  However, given the potential for abuse and the many watchful eyes of the government (the Southeastern Retina case was investigated by the U.S. Attorney’s Office, the HHS Office of Inspector General, the U.S. Office of Personnel Management, the FBI, and the Tennessee Attorney General’s Office) and wannabe whistleblowers, a periodic review of a provider’s billing practices is always a good idea.

CMS defines Modifier 25 as a significant, separately-identifiable Evaluation and Management (E/M) service performed by the same physician (or other qualified healthcare provider) on the same day of a patient’s procedure or other service.  The use of Modifier 25 indicates that on the billed day, the patient’s condition required service above and beyond the usual care associated with the scheduled services.  This therefore allows for increased reimbursement for a single day’s visit, rather than having to schedule the patient for another day to address a separate, significant problem, and can lead to increased patient – and provider – satisfaction.

However, as the Southeastern Retina settlement demonstrates, care must be taken when Modifier 25 is being considered.  The primary requirements must be met in every case in which the modifier is used:
  1. The E/M service must be significant. The additional problem must require medically necessary physician/provider work. For example, this could be a problem that requires treatment with a prescription or that would otherwise require another visit.
  2. The E/M service must be separate. The problem must be distinct from the other E/M service or procedure being done. Separate documentation is recommended to support the use of the modifier.
  3. The service justifying use of the modifier must be provided on the same day as the other procedure or E/M service.
  4. The modifier should be attached to the E/M code and the documentation must justify the code selected.
By keeping those basic requirements in mind, providers can take advantage of the benefits of Modifier 25, while maintaining full compliance in their billing practices.
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