Context to Attend ICAHN 2015 CAH Conference in Springfield, IL
According to the Centers for Medicare & Medicaid Services (CMS) Critical Access Hospital & Rural Health Fact Sheet Series1, a hospital must meet certain criteria to receive the CAH designation. Some of the requirements for the CAH designation include:
- Be located in a rural area or be treated as rural under a special provision that allows qualified hospital providers in urban areas to be treated as rural
- Maintain no more than 25 inpatient beds that may also be used for swing bed services. It may also operate a distinct part rehabilitation and/or psychiatric unit, each with up to 10 beds
- Have an annual average length of stay of 96 hours or less per patient for acute care
- Located more than a 35-mile drive from any hospital or other CAH; or
- Located more than a 15-mile drive from any hospital or other CAH in an area with mountainous terrain or only secondary roads
- Participates in Medicare - CAHs are paid for most inpatient and outpatient services to Medicare patients at 101 percent of reasonable costs
Context offers an array of solutions that address and offset some of the challenges CAHs routinely face. For example, ClaimsEditor® by Context4 Healthcare has been specifically designed by Context’s team of clinical experts to help CAHs, among other providers, achieve the following:
- Gain visibility into problems with the translation from clinical care to billing through our sophisticated rules engine and thousands of pre-built rules
- Prevent claim denials by providing actionable insight into resolution of the problems with messages on each issue uncovered, including potential options for resolution
- Identify training opportunities to address repetitive issues through error analysis
- Achieve claim compliance while enhancing overall operational efficiency
- Reduce audit risk by leveraging Context’s proprietary knowledgebase and comprehensive edits
ClaimsEditor allows health systems to check for accuracy in encounter entries to ensure consistency in medical records and payer reimbursements. Edits range from basic checks for accuracy of codes and
appropriate use of modifiers, to complex relationships such as utilization violations, mutually exclusive
services, diagnosis/procedure relationships, condition codes and areas of audit risk.
About the Illinois Critical Access Hospital Network (ICAHN)
ICAHN is a not-for-profit 501(c)3 corporation established in 2003 for the purposes of sharing resources, education, promoting efficiency and best practice and improving health care services for member critical access hospitals and their rural communities. ICAHN, with 53 member hospitals, is an independent network governed by a nine-member board of directors.
The mission of our organization is to strengthen Illinois critical access hospitals through collaboration. ICAHN will accomplish its mission through core network activities by:
- Ensuring appropriate funding and financial resources
- Continuing efforts to be recognized resource on critical access hospitals in Illinois
- Promoting efficient use of information technology services for the network and members alike
- Maintaining and further developing specific-type peer networks, activities and Listservs that promote hospital operational efficiencies and connectivity
- Offering ongoing educational opportunities and resources
- Developing and offering projects that are self-sustaining and which add value to the organization and its members
- Developing and offering shared services that offer value to members
