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Hospital case management departments should take the lead in making sure patients are placed in the right status by establishing a front-end process to make sure that problems in observation status vs. admission status dont occur.
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When Ocala (FL) Regional Medical Center announced a new screening initiative that would involve counseling nonurgent patients to seek alternative care, a funny thing happened: Local competitors Monroe Regional and Timber Ridge became involved when they heard about our initiative, because they felt they would be inundated by patients who were not having their treatment here, says Susan Atkin, RN, emergency department (ED) director.
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No one is claiming its a cure-all for emergency department (ED) overcrowding, but a number of facilities have turned to postponing elective surgeries that require admissions as an important part of a multifaceted plan to ease the burden on their harried ED staff. And when they do, many give the ED manager a key role in the decision-making process.
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While your facility, no doubt, has a Health Information Portability and Accountability Act (HIPAA)-compliance policy, which, among other things, covers electronic communications, it might be a good idea to craft one that is specific to your ED, experts say.
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Hospitals tread a fine line when it comes to placing patients in observation status. If patients dont meet criteria for observation, your claim probably will be denied.
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If its not currently doing so, your case management department should make use of your Program for Evaluating Payment Patterns Electronic Report (PEPPER) to identify areas where you may be overcoding or undercoding, medical necessity of admissions is questionable, or readmissions are too frequent.
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When Sonja Boone, MD, director of diversity for Northwestern Memorial Hospital in Chicago, talks to case managers about how they can provide patient-centered care to people from other cultures, she encourages them to talk directly to the patients about their beliefs and practices and about how the hospital can meet their needs.
