Articles Tagged With:
-
CMS Issues Temporary Halt to Short Stay Reviews
Faced with concerns from providers and apparently inconsistent education being provided by the Beneficiary and Family Centered Care Quality Improvement Organizations, CMS temporarily suspended reviews of short hospital stays and ordered the QIOs to re-review every denial issued since they took over the reviews.
-
Project to Improve Throughput Cut Length of Stay, Helped Bottom Line
A quality improvement project to shorten lengths of stay and improve throughput from the ED at Saint Francis Medical Center in Hartford, CT, decreased the length of stay by more than half a day from November 2015 through May 2016.
-
Know the Payer Rules to Maximize Reimbursement
In today’s world, it is imperative for the case management director to make sure the case management staff receives continuous training and education around payer rules and regulations, and the financial implications of what they do, says Mindy Owen, RN, CRRN, CCM, principal owner of Phoenix Healthcare Associates in Coral Springs, FL, and senior consultant for the Center for Case Management.
-
Review Every Patient, Every Day to Ensure Appropriate Reimbursement
When case managers concentrate only on getting the patient status right up front and then review only selected patients and review them every few days, it’s likely to have a big effect on the financial health of the hospital, says Brian Pisarsky, RN, MHA, ACM, associate director of Emeryville, CA-based Berkeley Research Group.
-
Take a Proactive Approach to Managing Denials Before They Occur
If hospitals are doing only denials management and not avoiding denials up front, they’re already behind, says Beverly Cunningham, RN, MS, consultant and partner at Oklahoma-based Case Management Concepts.
-
Case Managers are Link Between Clinical, Financial Sides
Today’s hospitals have to perform a balancing act between the clinical and financial sides of healthcare, focusing on providing top-quality care while following payers’ ever-changing rules and regulations and maintaining the bottom line.
-
CMS Proposes Eliminating Pain Management Questions
Agency says practice negatively affects opioid prescribing habits.
-
FDA Actions
In this section: The FDA approves new chronic hepatitis C treatment, greenlights a treatment course for primary biliary cirrhosis, and strengthens warning about the risk of acute kidney injury in several diabetes medications.
-
Patients Need More Education on Opioid Storage, Disposal
Recent survey discovers troubling trends.
-
Good News for Type 2 Diabetics
The rate of the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke among patients with type 2 diabetes mellitus was lower with liraglutide than with placebo.