Articles Tagged With:
-
Tips for Becoming a More Effective Leader
Case managers facing frustration and burnout can learn simple skills to reduce stress and become more effective leaders.
-
Career Outlook for Case Managers
In today’s hospitals, the role of case manager has expanded greatly as regulatory demands have increased. Case managers in large hospitals have moved into C-suite roles, where they can greatly influence the hospital’s processes and procedures to improve the patient’s experience and outcome. They also can address payer and regulatory issues.
-
Online, Classroom, Team Huddles: For Training, All That (and More) Is Needed
The amount of needed education for patient access is only increasing. How can leaders help staff keep up?
-
Optimizing COPD Discharge Planning
Patients are not one size fits all when discharged with COPD. However, in readmission rates they are all lumped together, one expert says.
-
Some Patients Present With ‘Hidden’ Insurance Coverage; Patient Access Can Uncover It
Certain patients who say they do not have any insurance actually are covered in some way. It is the job of patient access staff to find it — and avoid uncompensated care for the hospital.
-
Healthcare Facility Uses Lean Principles to Enact Systemwide Culture Change
A hospital’s process improvement (PI) could begin with a focus on reducing gaps in quality service. The Cleveland Clinic started such a process, focusing on engaging all employees in process improvement — rather than leaving the work to one PI team.
-
Risk Assessment Tool Helps Identify People in Need of Case Management
The Valley Risk Assessment Tool, created by The Valley Hospital of Ridgewood, NJ, is a two-page, two-column chart that assigns a level to each category of risk.
-
Payers, Hospitals Disagree About Whether Patient Meets Inpatient Criteria
Payers are refusing to pay claims for gastric bypass, joint replacement, and even cataract extraction. Why? Because documentation in the record does not support the need for surgery.
-
Tips to Improve Quality and Efficiency in Case Management Departments
One of the first steps to streamline case management operations is to reassign staff to new roles, such as focused discharge planning jobs and utilization review.
-
Missing Clinical Documentation Reason for Many Claims Denials
More health plans are asking for certain pieces of clinical documentation before paying claims. If it is not there, the claim is denied. What are the specific issues arising?