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Patient access leaders should expect surveyors from The Joint Commission or the Centers for Medicare and Medicaid Services (CMS) to interact directly with front-line staff in registration areas.
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Patients rely on patient access employees to inform them of out-of-pocket costs, but accurate estimates are challenging to give. This challenge is due to changes in what is done clinically, provider contracts, patient co-morbidities, and the complexity of coverage.
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Patient access employees are responsible for knowing the general policies and procedures of the hospital, emphasizes Angela Click, patient access services manager at OSF St Joseph Medical Center in Bloomington, IL.
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Case managers should know their patients insurance benefits and out-of-pocket expenses when they develop a discharge plan to make sure the patient can afford the plan they are putting in place.
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As outbreaks continue to be reported due to unsafe injection practices and improper use of medication vials, the Centers for Medicare & Medicaid Services (CMS) is telling its surveyors to contact public health departments immediately if they see such flagrant breaches of infection control.
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At Good Samaritan Medical Center in West Palm Beach, FL, a throughput initiative that uses colored magnets to indicate anticipated discharges has cut emergency department holding time and increased the number of discharges by 2 p.m.
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After Southeast Alabama Medical Center in Dothan began a heart failure readmission prevention program, its 30-day readmission rate dropped to an average of 13%. In January, the hospital discharged 62 heart failure patients and only 8% were readmitted.
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When patients benefits have been maxed out or are close to being maxed out, case managers need to be creative with discharge planning, experts say.
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Bioethicists can advocate for improved communication with family caregivers when a patient is going to be discharged from the hospital.
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When BK Kizziar, RN-BC, CCM, was in the hospital following surgery, a case manager walked into her room the day before discharge and asked whether she wanted to go to an acute rehab facility or have physical therapy sessions at home.