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If your case management department isn't involved in the business side of health care, you're missing opportunities to affect your hospital's bottom line and to ensure that your patients get the most effective, cost-efficient care.
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Faced with an audit that eventually revealed millions of dollars in Medicare overpayments for short-stay patients placed in the wrong admission status, Saint Joseph's Hospital in Atlanta began a series of proactive steps to correct the problem, educate staff, and assure that InterQual criteria are applied correctly.
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By reviewing the discharge dispositions of patients whose hospital stay was covered by the Medicare post-acute transfer rule, Jupiter (FL) Medical Center in Florida was able to generate an additional $108,000 in reimbursement in just one year.
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Three years ago, the management team at Orlando Regional Healthcare System took a hard look at managed care denials, recalls Craig Pergrem, CHAM, MBA, corporate director of patient business, and asked, "What can we do to stop the bleeding?"
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Pregnant women who come to the ED with abdominal pain often are misdiagnosed and undergo unnecessary appendectomies, says a new study.
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This paper gives the results of the substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular Tachycardia (SMASH-VT) study. This study was designed to test the hypothesis that early prophylactic catheter ablation in patients with implantable cardioverter defibrillators (ICD) would decrease the frequency of ICD shocks during follow-up.
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This remarkable study is a population analysis of a huge cohort of children in Denmark who were followed, since 1930 or later, for the presence of coronary heart disease (CHD), and had all mandatory annual examinations at schools in Copenhagen.
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An early invasive approach is preferred for higher risk non-ST elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of cardiac catheterization is not clear.
