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In 1999, Presbyterian Hospital of Dallas had a denial rate of 1.12% of gross revenue at year end. The denial rate began to decline steadily following the implementation of a denials management team and process improvement teams, both of which include members of the case management staff. The process has saved millions of dollars. For fiscal year 2003, the denial rate has dropped to 0.2% of gross revenue.
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When it comes to improving quality, sometimes the simplest and least expensive measures work best, reports Earl Kurashige, RN, project manager for Qualis Health, a nonprofit health care quality improvement organization based in Seattle.
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Descriptions of the following positons: Payer specialists, Placement specialist, Denials management specialist, Staff assistants and Department secretary.
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In this first part of a two-part series on benchmarking, we tell about two hospitals that achieved dramatic reductions in length of stay (LOS). Next month, we discuss how to speed up admissions by addressing virtual capacity issues with the entire hospital.
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Are admitted patients being held for a long time in the emergency department while they wait for an inpatient bed to become available? Do patients in specialty care units stay longer than necessary because there is no general unit bed for them to be transferred to?
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The trauma team at Borgess Medical Center in Kalamazoo, MI, refers to Dorothy Malcolm, RN, BSN, as the glue that holds us all together. As trauma case manager, Malcolm coordinates care for trauma patients from the time they come into the emergency department (ED), during their entire stay in the hospital and while they are being treated in the outpatient follow-up clinics.
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In April 2002, Donna Zazworsky, MS, RN, CCM, FAAN, director of grants, partnerships, and policy at St. Elizabeth of Hungary Clinic in Tucson, AZ, got a telephone call from a case manager at a local hospital who wanted to know if the clinic had a hospital bed it could donate for use by a 17-year-old patient who was being discharged.
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The Centers for Disease Control and Preventions (CDC) Advisory Committee on Immunization Practices (ACIP) has released its revised recommendations for the prevention and control of influenza.
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