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Patient access areas are seeing more procedures requiring authorization, a surge in the number of insured patients, and more clinical requirements from payers. All of these factors make an increase in claims denials and much lost reimbursement very likely.
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A readmission reduction collaborative of San Francisco Bay-area hospitals and their post-acute partners has reduced hospital readmissions by 20% among participating hospitals, preventing more than 4,000 readmissions.
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When the Medicare Administrative Contractors (MACs) conduct probe and educate prepayment audits of compliance with the two-midnight rule, inadequate documentation and lack of one or more of the components of certification are major reasons for the denials, according to Ralph Wuebker, MD, MBA, chief medical officer for Executive Health Resources, a Newtown Square, PA, healthcare consulting firm.
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A bill signed into law on April 1 directs the Centers for Medicare & Medicaid Services (CMS) to postpone post-payment audits of the two-midnight rule until after March 31, 2015. In the meantime, CMS has implemented pre-payment probe and educate reviews to determine if hospitals are in compliance.
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There is no magic template for initiating a self-scheduling practice, but there are some strategies hospital employee health departments could employ that will help reduce health care workers work-family conflict (WFC) stress.
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Nurses are at high risk of stress caused by work-family conflict (WFC) partly because of the physical and emotional demands of their long shifts. One solution could be to permit some worker self-scheduling, an expert says.