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Multidisciplinary rounds can be an invaluable tool for the hospital team, but only if they are well-organized and focused, experts say.
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Patient access leaders at The University of Texas M.D. Anderson Cancer Center in Houston created a visual tool in 2013 to help staff to determine the correct payer.
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Multidisciplinary rounds are a good way to improve throughput, reduce length of stay and readmissions, and improve patient satisfaction, experts say.
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It seems that every year case managers are asked to take on more and more roles and functions. Every time a new rule or regulation comes out from the Centers for Medicare & Medicaid Services (CMS), administrators turn to case management as the group to take the new problem or task on. This translates to more work!
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Weekly extended stay rounds help move along patients who have issues and barriers to a timely discharge, experts say.
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Even if the patient standing in front of you obtained coverage on the Health Insurance Exchange Marketplace, the claim still could end up being denied.
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At University of Utah Health Care, a transition case manager acts as a liaison between the outpatient care team at community clinics and the inpatient care team.
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A program in which case managers coordinate the care of members with complex medical conditions and those who are at high risk for chronic diseases has paid off for Care Choices HMO of Farmington Hills, MI.
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A depression management program has resulted in better scores on Health Plan Employer Data Information Set (HEDIS) measures and a reduction in depression screening scores for Fallon Community Health Plan, with headquarters in Worcester, MA.
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When it comes to accepting cash payments from providers in exchange for referrals, there is no question: It is expressly forbidden. But what happens with noncash items, such as the seemingly innocuous gifts that show up around the holidays or the New Year. What are the rules?
