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Working for 10 years as emergency department nursing manager at St. Mary's Hospital in Tucson, AZ, Cassandra Pundt, RN, CEN, recalls she was constantly struck by the "tremendous need" for a patient advocate specifically dedicated to the ED.
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Remember that the case manager-physician relationship is like a marriage and you have to keep working at it to make it a good one, says Steve Blau, MBA, MSW, LCSW-C, director of case management for Good Samaritan Hospital in Baltimore.
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It's frustrating when you point out that a patient doesn't meet acute care criteria or that documentation in a chart is not complete and nothing happens, even if you take it to your physician advisor.
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When it comes to talking with physicians about documentation or admissions criteria, it's often not what you say but how you say it that helps you get an answer.
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Communication between hospitals and the primary care providers in the community is essential in managing the care of the uninsured, asserts Diana Resnik, vice president of community care for Seton Healthcare Network in Austin, TX.
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In September 1999, INTEGRIS Health asked 10 employees from their two Oklahoma City hospitals, INTEGRIS Southwest Medical Center (ISMC) and INTEGRIS Baptist Medical Center (IBMC), to redesign certain elements of admitting, case management, medical records, and billing practices.
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Higher patient copays and increasing numbers of people who are working but not insured have made the management of self-pay accounts a more crucial issue than ever for most of the nations hospitals.
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Faced with a growing number of uninsured patients and rapidly escalating costs for treating them, Brackenridge Hospital in Austin, TX, created a case management program for the uninsured that has resulted in shorter lengths of stays (LOS), fewer readmissions, and less utilization of the emergency department (ED) by patients being managed.
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Providing medical care for the uninsured should be a community initiative and not just the responsibility of hospitals that provide indigent care, asserts Donna Zazworsky, MS, RN, CCM, FAAN, director of community and outreach for St. Elizabeth of Hungary Clinic in Tucson, AZ.