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On Monday, July 2, 2007, a Medicare patient in a metropolitan hospital, whom we'll call Mrs. Jones, was notified by her physician that she was to be discharged the next day.
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New rules and guidelines for Medicare Discharge Plan Appeals known officially as the "Important Message from Medicare about Your Rights" (IM) require hospitals to respond to appeals at any time, including weekends and holidays.
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The length of stay for patients being discharged to skilled nursing facilities from St. Joseph's Hospital progressive ventilator care unit dropped by 7.5 days (a 47% reduction) following a Six Sigma pilot project that focused on better ambulation of patients, earlier screening for potential skilled nursing admissions, and timely discharge.
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By educating emergency department supervisors on admissions criteria and community resources, Weatherford Regional Medical Center in Weatherford, TX, has managed to eliminate most social admissions to the hospital and ensure that patients who are admitted meet admission criteria.
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When it comes to the crucial arena of charge capture making sure that providers are paid at the appropriate level for all services rendered it's all about "the right charges and the right resource putting the charges in," says Gala Prabhu, a New York City-based senior manager for Accenture.
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Today's case managers report that they are paid more but they're working longer hours and being asked to do more documentation and paperwork.
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Putting the "know" before the "why" for patient access employees was the focus at Stevens Hospital in Edmonds, WA, during implementation of its procedure for distributing the revised "Important Message From Medicare," says Evita Armijo, patient access manager.
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A recent announcement by the Centers for Medicare & Medicaid Services (CMS) that it will no longer pay for care required because of hospital error has implications for patient access.
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Cell phones replaced land-based pagers at Richland Hospital in Richland Center, WI, when the area was hit by severe storms and flooding in late August.
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IRB members often begin their new role with many questions and concerns. While these may be answered during a formal training program, there is another way to help ease new members into the role, and that's through a formal mentoring program.
