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Uncollectible funds, or "bad debt," is a problem your patient access department can't afford to ignore. With increasing numbers of self-pay, uninsured, and underinsured patients access managers should revamp processes sooner rather than later.
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By dedicating a wing of the hospital to patients being cared for by hospitalists, St. Mary's Health Center in St. Louis has decreased the length of stay by 4% compared to a 2% reduction in the non-hospitalist unit, as well as improved patient satisfaction and decreased the 30-day readmission rate for patients on the hospitalist unit.
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It sounds fairly cut and dried: If an authorization isn't obtained from a payer, the claim will be denied. However, payer requirements are getting more and more complex and stringent.
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A series of initiatives at Central DuPage Hospital has helped decrease length of stay and improve patient flow, according to Corinne Haviley, RN, MS, associate chief nurse at the 313-bed hospital in Winfield, IL.
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By implementing a series of patient flow initiatives over a 10-month period, UC Health University Hospital, a 693-bed academic medical center in Cincinnati, was able to decrease the average patient length of stay by 5.34 hours, giving the hospital the ability to serve 1,300 more patients each year.
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As they wait to learn the next steps in health care reform, case managers should start thinking about what they need to do to get ready for the future, says Beverly Cunningham, RN, MS, vice president, clinical performance improvement, Medical City Dallas Hospital.
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As the Centers for Medicare & Medicaid Services and commercial payers move to base reimbursement on quality and consumers become more savvy about their choices of health care providers, complete and accurate documentation will become even more important.
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Yes, we've all heard this tongue-in-cheek summary of why surgery is used to determine what is wrong with a patient. Supposedly, an operation gets to the patient's underlying problem. The message is not subtle.