Hospital Case Management – May 1, 2017
May 1, 2017
View Issues
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Hospitals Are Still Confused About Inpatient vs. Observation
It’s been nearly four years since the Centers for Medicare & Medicaid Services announced its Two-Midnight Rule, but hospital staff still are grappling with the gray areas in the rule.
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Be Proactive: Review Your Short Stays Before They Are Billed
Case management directors should take a proactive approach to managing denials and monitor their short inpatient stays, watch for trends, and prevent inappropriate short-stay admissions.
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Top 10 Potentially Inappropriate Stays
The following is a list of potentially inappropriate stays from the Office of Inspector General.
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OIG: Hospitals Are Still Getting Patient Status Wrong
A report by the U.S. Department of Health and Human Services Office of Inspector General, released in December 2016, concluded that hospitals are billing for short inpatient stays that are inappropriate under the Two-Midnight Rule and for long outpatient stays.
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Why the Two-Midnight Rule Is ‘Clear as Mud’
There are patients whose condition and circumstances put them in the shadowy area between meeting criteria for an inpatient stay and being an outpatient with observation services.
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Observation Unit Cuts Length of Stay, Lowers Costs
Patients who were transferred to the Outpatient Observation Unit at Rockford (IL) Memorial Hospital experienced lower lengths of stay and lower costs than patients who were candidates for observation services but were treated on an inpatient unit.
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CMS Delays Start of Cardiac Bundled Payment Initiative
CMS has delayed the effective date of two bundled payments initiatives from July 1 to Oct. 1.
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Behavioral Healthcare in ED Improved With Telepsychiatry
Quality of care for behavioral health patients in the ED has been dramatically improved at Rideout Regional Medical Center in Marysville, CA, with a program that aims to get professional help to people in need as soon as possible.