Articles Tagged With: Insurance
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Safety Strategies to Minimize AI Risks in Healthcare
Patient safety and risk management strategies for AI in healthcare are crucial for avoiding liability and preventing medical errors.
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Volunteers Need Screening and Training to Avoid Liability Risks
Volunteers serve many important roles in a hospital, but they can bring potential liability. A risk mitigation plan can help healthcare organizations make the most of volunteers without exposing themselves to undue risks.
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‘Payvider’ Model Is a New Trend for Care Coordination and Addressing Social Needs
Case management and care coordination often are seen as ways to improve patient care outcomes, reduce readmissions, and make hospital-to-community care more efficient. However, resources remain limited in care coordination efforts because of the payment disincentive. A solution that is gaining steam is the “payvider” model.
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Check Insurance Coverage for Natural Disasters
Healthcare organizations should know if they are adequately insured for natural disasters. Organizations should review their policies with their insurance agents to understand what coverage they have for natural disasters and what additional coverage they might need.
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Case Management Interventions Can Improve COPD Treatment Adherence
Medication adherence rates for treatment of COPD are low. The results of research suggest fewer than half of patients with the chronic illness take their medication properly.
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Challenges in Accessing Resources Lead to ED Psychiatry Consults
Difficulty identifying the “right” level of care for patients, understanding how insurance plays a major role in post-ED care options, and needing help with the operational process of making referrals to outside treatment facilities all are administrative and bureaucratic headaches with which clinicians could use assistance.
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Ethical Responses if Family Abandons Loved One at Hospital
By leveraging their mediation skills, ethicists can build trust between weary family caregivers and clinicians who are unsure about how to handle a delicate situation. This can help everyone identify patient needs and find possible solutions.
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Clinicians Are Ethically Obligated to Consider Financial Side of Care
Clinicians should include the cost of care in discussions, help patients access charity care or financial counseling, and screen patients for social determinants of health.
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Build a Healthy Relationship with Insurance Providers
It can be a tense relationship. Healthcare systems and providers — including case managers — have admitted it sometimes feels like insurance is the enemy, and patients have been known to carry that same sentiment. How should case managers and other healthcare professionals work out a healthy connection with insurance companies, and even work to strengthen that connection to help build a more positive view of the relationship among healthcare, insurance, and the patient?
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Thinking Like a Payer
Part of what makes so many case managers successful is their ability to understand countless roles within healthcare and move between them smoothly. Whether managing discharges, providing social work support, or completing utilization review, the case management experience often is varied. However, many struggle in the quest to work more seamlessly with payers.