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Under newly published Medicare requirements, hospitals now may complete a history & physical (H&P) within 30 days of outpatient surgery, and it must be added to the record within 24 hours of admission.
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The Centers for Medicare and Medicaid Services (CMS) has approved a pass-through payment that provides additional device payments for the X STOP procedure when the device is implanted in a hospital outpatient setting.
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If your hospital doesn't have case managers who are dedicated to the emergency department (ED) and who work during peak hours, you're missing an opportunity to improve patient throughput, reduce denials, and cut down on patients who return to the ED over and over.
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It's not necessary to have a case manager in the emergency department 24 hours a day, seven days a week, and case managers don't necessarily have to screen every patient who comes into the ED, says Toni Cesta, RN, FAAN, vice president, patient flow optimization for the North Shore-Long Island Jewish Health System.
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The Centers for Medicare & Medicaid Services (CMS) took additional steps toward value-based purchasing and transparency in health care in the final rule for Medicare payment for outpatient services issued Nov. 1.
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An initiative that includes capacity alerts, "hall beds" used when the hospital is approaching capacity, and having one person responsible for coordinating bed placement has helped Spartanburg (SC) Regional Medical Center improve patient throughput and avoid being on emergency department diversion for more than a year.
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A documentation enhancement project that pairs case managers and coders increased the Medicare case-mix index at North Mississippi Medical Center from 1.48 to 1.92 in six years for the Tupelo, MS, hospital.
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When Cooley Dickinson Hospital (CDH) in Northampton, MA, put the first case manager in its emergency department, some of the staff were skeptical about how well the initiative would work, recalls R.F. Conway, MD, medical director of emergency services and chief of emergency medicine.
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The successful integration of case management and disease management is the latest step in the ongoing evolution of the Sutter Health Sacramento Sierra Region Care Management Programs, says Jan Van der Mei, RN, the region's continuum case management director.