Hospital Case Management
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Get ready: Bundled payments are in your future
The Centers for Medicare & Medicaid Services’ mandatory bundled payment pilot project makes clear that the agency intends to reform Medicare reimbursement.
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California staffing law reduces occ injuries; nurses in other states fighting for similar laws
A 2004 California law mandating specific nurse-to-patient staffing standards in acute care hospitals has significantly lowered job-related injuries and illnesses for both registered nurses and licensed practical nurses, researchers report.
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Letter explains observation services, financial obligations
Several years ago, faced with increased complaints about out-of-pocket expenses from patients who received observation services rather than being admitted, the case management department at Northwestern Lake Forest Hospital began giving patients in observation a letter explaining the difference in inpatient and observation status.
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Hospital revamped admission process to comply with two-midnight rule
When CMS issued the two-midnight rule in 2013, the case management department at Northwestern Lake Forest (IL) Hospital began an initiative to change the admission process to comply with the new regulations.
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Educate observation patients on what 'observation' means to them
Many patients receiving observation services believe they have been admitted to the hospital until weeks after discharge when they get a substantial bill for their share of services.
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Beef up your documentation reviews to ensure reimbursement is appropriate
Many of the problems the Medicare Administrative Contractors have cited during their Probe and Educate audits revolve around documentation, says Bridget Gulotta, RN, senior consultant for The Camden Group, a national healthcare consulting firm.
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Inpatient vs. Observation: Will it Ever be Clear?
CMS issued the two-midnight rule in 2013 but even after three rounds audits by the Medicare Administrative Contractors, hospitals still struggle to get it right.
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The Top 10 Mistakes You May Be Making In Your Case Management Department!: Part 2
Last month, we began our discussion of the top 10 mistakes you may be making in your case management department. After 30 years of experience in testing and retesting hospital case management models, it is safe to say that we have identified some basic elements that make for a contemporary and state-of-the-art case management department. In this month’s Case Management Insider, we will continue our discussion of the top 10 mistakes by reviewing mistake numbers 3-5.
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Get ready for ICD-10: It’s really going into effect
After a series of fits and starts, it appears that ICD-10 will take effect on Oct. 1.
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IPPS proposed rule is more of the same with emphasis on quality
When the University of Wisconsin Hospital and Clinics embarked on its discharge collaborative project to improve patient satisfaction with the discharge process, the organization’s Patient and Family Advisors were an important part of the process.