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  • Case Management Insider: Solution: Committees on organizational ethics

    One solution to perennial problems such as ethics issues might be the formation of an organizational ethics committee. Different from a clinical ethics committee, an organizational ethics committee deals with organizational dilemmas that should be solved in a formalized manner.
  • Provider-preventable conditions face cuts

    Now that the Centers for Medicare and Medicaid Services (CMS) has launched a program that adjusts Medicaid payments for provider-preventable conditions, including healthcare-acquired conditions, it's essential for case managers to work with physicians to make sure all conditions that are present on admission are clearly documented on a patient's chart.
  • Case Management Insider: The process of ethical decision-making

    The ethical decision-making process is similar to the case management process and the nursing process. The steps include:
  • Action plan maximizes payment, reduces costs

    Since beginning a "financial advocacy initiative," Advocate Illinois Masonic Medical Center in Chicago has seen nearly a 160% increase in its point-of-service (POS) collections.
  • Don't give patients wrong benefits info

    If you tell patients they owe their entire deductible of $2,000 for an inpatient procedure, and they know that $1,700 of the deductible already was met, your credibility and competence are suddenly in question.
  • ED registrars often ID 'suspicious answers'

    Some emergency department (ED) patients are destitute, drug-seeking, or have nowhere else to obtain care, and they might pass themselves off as others to obtain insurance coverage, says Marsha Kedigh, RN, MSM, director of admitting, emergency department registration, discharge station, and insurance management at Vanderbilt University Hospital in Nashville.
  • No bed available? Keep patient satisfied anyway

    If a worried and anxious patient or family member is kept waiting, it might help to convey the underlying reasons for delays in registration, treatment, or room placement, says Diane Manuel, director of patient access for admissions and the emergency department at Wake Forest University Baptist Medical Center in Winston Salem, NC.
  • Handle red flags differently in the ED

    Suspected 'red flags' must be handled differently in the emergency department than other registration sites, according to Joyce L. Predmore, associate director of patient access services at Ohio State's University Hospital East in Columbus.
  • Did registrar complain? It's an opportunity

    Do you overhear registrars making remarks such as "We were slammed this morning!" or "We don't have enough staff today?" You'll need to re-evaluate your staffing levels to be sure the department is providing optimal coverage and customer service, says Kathleen Bowles, LSW, patient access supervisor at The Ohio State University Medical Center in Columbus.
  • Can't do what staff are asking? Explain

    The results of a survey of registration staff at University Orthopaedic Center, part of Salt Lake City-based University of Utah Health Care, were a little surprising to managers.