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    Home » Newsletters » Hospital Case Management

    Hospital Case Management

    www.reliasmedia.com

    November 1, 2008

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    Hospital Case Management 2008-11-01

    Improve documentation, fine-tune admissions process before RACs arrive

    As the Centers for Medicare & Medicaid Services (CMS) rolls out the Recovery Audit Contractor (RAC) program nationwide, case managers are in a position to help their hospitals stay ahead of the curve by keeping patients out of the hospital if they don't need to be admitted and ensuring that the documentation in the medical record for inpatient or observation admission supports medical necessity. Read More

    Ensuring that patients meet admission criteria

    Of the nearly $1 billion the Recovery Audit Contractors (RACs) identified in improper payments to hospitals and other providers, nearly 40% was the result of medical necessity denial for inpatient admissions, points out Deborah Hale, CCS, president, Administrative Consultant Service LLC, a Shawnee, OK, consulting firm. Read More

    Monitor your facility's use of Condition Code 44

    If your hospital frequently uses Condition Code 44 to change a patient's admission status, you may need to take a fresh look at your admissions process, according to Deborah Hale, CCS, president, Administrative Consultant Service LLC, a Shawnee, OK, consulting firm. Read More

    Documentation goes beyond correct MS-DRG

    At DCH Health System in Tuscaloosa, AL, clinical documentation improvement efforts go far beyond just making sure the documentation supports the most appropriate MS-DRG for the purpose of Medicare reimbursement. Read More

    Critical Path Network: Patient flow initiative reduces hours on hold, decreases length of stay

    Since Baptist Memorial Hospital-Memphis began a patient throughput initiative, the patient holding hours in the emergency department and post-anesthesia care unit average less than 30 hours per day despite the fact that 50,000 patients come through the emergency department each year and the hospital has more than 30,000 inpatient visits a year. Read More

    Critical Path Network: Acute care NP helps community-based MDs

    When patients of community-based physicians are ready for discharge from Chesapeake (VA) Regional Medical Center, they no longer have to wait for their physicians to come to the hospital and write discharge orders. Read More

    Critical Path Network: Research, collaboration makes successful NP model

    When Chesapeake General Hospital began exploring ways to improve patient throughput and further reduce its length of stay, Roxana Ballinger, RN, BBA, CCM, director of care management, conducted research to discover what other hospitals had done to improve patient throughput and determined that nurse practitioners could play an important role in moving patients through the continuum. Read More

    Constant analysis helps improvement team succeed

    At DCH Health System, the clinical documentation improvement team takes a proactive approach to changes in the Centers for Medicare & Medicaid Services (CMS) documentation requirements. Read More

    Access Management Quarterly: Make staff aware of payer requirements

    Automobile and accidental injury regulations, the Medicare as Secondary Payer questionnaire, and workers' compensation guidelines are just a few of the many issues with which the patient access professional and case manager must be educated and competent. Read More

    Access Management Quarterly: Hospital averages $6M in front-end collections

    An enterprisewide master patient index is used at Methodist Le Bonheur Healthcare, a system of six hospitals, several off-campus diagnostic and treatment centers, free-standing surgical centers, and urgent care centers. Read More
    www.reliasmedia.com

    Hospital Case Management

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    Hospital Case Management 2008-11-01
    November 1, 2008

    Table Of Contents

    Improve documentation, fine-tune admissions process before RACs arrive

    Ensuring that patients meet admission criteria

    Monitor your facility's use of Condition Code 44

    Documentation goes beyond correct MS-DRG

    Critical Path Network: Patient flow initiative reduces hours on hold, decreases length of stay

    Critical Path Network: Acute care NP helps community-based MDs

    Critical Path Network: Research, collaboration makes successful NP model

    Constant analysis helps improvement team succeed

    Access Management Quarterly: Make staff aware of payer requirements

    Access Management Quarterly: Hospital averages $6M in front-end collections

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