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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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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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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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The quality professionals role continues to evolve, with many professionals stepping into leadership and business roles, according to the latest Hospital Peer Review salary survey.
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A high priority has been placed on improving incident reporting as the first step in reducing unintended patient injuries. The incident reporting system in many health care organizations is evolving into one that focuses on near misses, provides incentives for voluntary reporting, ensures confidentiality (not necessarily anonymity), and emphasizes data collection, analysis, and improvement.
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A recent four-day Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey at United Regional Health Care System in Wichita Falls, TX, was very patient-focused, with direct caregivers much more involved, reports Darlene Adams, RN, MSN, the organizations patient care safety/quality management officer.
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Are you tired of dealing with multiple data definitions and similar but differing performance measures? Youve probably wished many times that the quality measures from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Centers for Medicare & Medicaid Services (CMS) were identical.
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Work stress and dissatisfaction with the work environment may hasten the retirement of aging nurses, according to a study by the Center for American Nurses, an Austin, TX-based affiliate of the American Nurses Association.
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When the Joint Commission on Accreditation of Healthcare Organizations introduced its periodic performance review (PPR) tool in November 2003, there was a single important criticism from the organizations that completed it: They wanted the tool to be available to them all the time, not just once every three years.
