Hospital Case Management – August 1, 2015
August 1, 2015
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Inpatient vs. Observation: Will it Ever be Clear?
CMS issued the two-midnight rule in 2013 but even after three rounds audits by the Medicare Administrative Contractors, hospitals still struggle to get it right.
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Beef up your documentation reviews to ensure reimbursement is appropriate
Many of the problems the Medicare Administrative Contractors have cited during their Probe and Educate audits revolve around documentation, says Bridget Gulotta, RN, senior consultant for The Camden Group, a national healthcare consulting firm.
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Educate observation patients on what 'observation' means to them
Many patients receiving observation services believe they have been admitted to the hospital until weeks after discharge when they get a substantial bill for their share of services.
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Hospital revamped admission process to comply with two-midnight rule
When CMS issued the two-midnight rule in 2013, the case management department at Northwestern Lake Forest (IL) Hospital began an initiative to change the admission process to comply with the new regulations.
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Letter explains observation services, financial obligations
Several years ago, faced with increased complaints about out-of-pocket expenses from patients who received observation services rather than being admitted, the case management department at Northwestern Lake Forest Hospital began giving patients in observation a letter explaining the difference in inpatient and observation status.
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California staffing law reduces occ injuries; nurses in other states fighting for similar laws
A 2004 California law mandating specific nurse-to-patient staffing standards in acute care hospitals has significantly lowered job-related injuries and illnesses for both registered nurses and licensed practical nurses, researchers report.