Hospital Case Management – January 1, 2010
January 1, 2010
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If you thought the RACs were a pain, just wait for what's coming next
By the end of the year, it's likely that every type of medical record in your hospital will be scrutinized by one auditor or another, predicts Brian Flood, managing director for KPMG LLP, the U.S. audit, tax, and advisory firm. -
Hospital reimbursement from all payers is at risk
If your hospital has been focusing solely on improving Medicare records in preparation for the permanent Recovery Audit Contractor (RAC) program, you may find yourself in a bind as other payers roll out their own audit programs. -
Documentation is the key when issuing HINNs
If you aren't complying with the Centers for Medicare & Medicaid Services (CMS) requirements for issuing Hospital Issued Notices of Noncoverage (HINNs) and documenting them well, your hospital could face severe repercussions down the road, according to Jackie Birmingham, RN, MS, CMAC, vice president of regulatory monitoring for Curaspan Health Group, a Newton, MA, health care technology and services firm. -
Critical Path Network: Follow-up calls help patients adhere to treatment plan, avoid readmissions
In an effort to improve transitions of care, the nurse care coordinators at Brigham and Women's Hospital in Boston make follow-up calls to patients who have been discharged, identify problems and solve them, and answer questions the patients may have about medication, symptoms, or their discharge plan. -
Critical Path Network: Throughput drive lowers discharge time, LOS
When Henrico Doctor's Hospital in Richmond, VA, launched a hospitalwide initiative to improve patient throughput, the team was able to shave 2.5 hours off the average discharge time and decrease the average length of stay on the medical unit from almost 10 days to five days in the first six months of the project. -
Critical Path Network: Hospital created simple, effective discharge tool
An effective and simple discharge checklist is the ideal tool for hospital nurses and others who handle the patient discharge process. -
Hospital appeals, receives about $2 million in denials
Bon Secours St. Francis Health System received nearly $2 million in denials and successfully appealed the vast majority of them during the few months the Greenville, SC, hospital was part of the Recovery Audit Contractor (RAC) demonstration project, says James T. Jones, PhD, RN, administrative director, case management and patient documentation for the Bon Secours St. Francis Health System. -
Studies show decrease in senior care continuity
If the discharge planning community's ideal is to begin the discharge process at the door, when patients are admitted to the hospital, then community provider input is necessary for a smooth care transition. -
Discharge often difficult at children's hospitals
A researcher and pediatric physician who has studied insurance and immigration issues related to medical care has found that several myths create an emotional response that complicates the medical and political issue of who should pay for health care for undocumented immigrants. -
2009 Salary Survey Results: Salaries on the rise — but so are the hours
Salaries for case managers are increasing, but the vast majority of case managers are working far more than the typical 40-hour week, according to the 2009 Hospital Case Management Salary Survey.