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Continuing to stress the importance of discharge planning and preventing unnecessary readmissions, the Centers for Medicare & Medicaid Services (CMS) has issued a revised set of Discharge Planning Interpretive Guidelines that surveyors will use to assess a hospital's compliance with Medicare's Conditions of Participation. The guidelines do not apply to critical access hospitals, which must follow a different set of Conditions of Participation.
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Use documents as proof you talked to patients
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The administration at Scottsdale (AZ) Healthcare System thinks it so important for the Important Message from Medicare (IM) to be delivered correctly that all case managers go through extensive training on when and how the IM should be given to patients.
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The role of the hospital case manager has taken many twists and turns over the past two decades. Case management started out as a sectioned-off role of utilization review without any relationship to the direct care providers or interdisciplinary care team.
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In the newly revised Discharge Planning Interpretive Guidelines, the Centers for Medicare & Medicaid Services (CMS) includes what it calls "blue boxes" that advise hospitals on best practices in discharge planning and care transitions.
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Medicare requirements for issuing the Important Message from Medicare (IM) and the Hospital-Issued Notices of Noncoverage (HINNs) have been around so long that they sometimes get short shrift.
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After a series of delays, the U. S. Department of Health and Human Services has set Oct. 1, 2014, as the firm date for implementation of the ICD-10 procedure and diagnostic coding set.
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When hospitals determine that the care patients are receiving or are about to receive will not be covered by Medicare because it is not medically necessary, not delivered in an appropriate setting, or is custodial in nature, the hospital should provide the patient with a Hospital-Issued Notice of Noncoverage (HINN) to inform them that they will be responsible for the bill if they choose to stay in the hospital.
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