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Access managers continue to debate the intricacies of the Emergency Medical Treatment and Labor Act, despite the publication of an EMTALA final rule on Sept. 9, 2003, by the Centers for Medicare & Medicaid Services.
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Think beyond the patient when SARS is suspected; JCAHO quality reports available on Internet; Grievance vs. complaint clarified in SHCA guide
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About a year ago, Tara Tinsley, CHAM, access supervisor and department trainer for Childrens Health System in Birmingham, AL, says she came up with the idea of having separate policies and procedures for the various access areas.
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A woman with diabetes who has struggled with compliance for years before getting her disease under control told Gayle McLaughlin, RN, BSN, Every time I start to go off track, I keep hearing your voice in my head.
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When it needed to hire nine nurse care managers for its in-house diabetes management program, Fallon Community Health Plan found a way to overcome the areas nursing shortage. It gave the nurse care managers in the diabetes program the opportunity to work flexible hours.
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More and more often, case managers are being called on to demonstrate their value by reporting on outcomes. But there are no hard-and-fast rules as to what outcomes to measure because they differ from organization to organization, says Mary Jane McKendry, RN, CCM, MBA, director of education, training, and consulting for McKesson Health Solutions.
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Coaching diabetics to make lifestyle changes, helping members overcome issues that affect their compliance, and offering classes to help patients cope with chronic disease have paid off for MVP Health Cares award-winning Diabetes Care program.
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Case managers at Oxford Health Plans have a new set of tools to help noncompliant members in the plans diabetes disease management program.
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After four years of positive experiences with a national disease management vendor, Fallon Community Health Plan in Worcester, MA, decided it would be more beneficial to members and providers if the diabetes management program was transitioned in-house.
