Hospital Management Topics
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Price Transparency: Ethicists Can Play a Role
Hospitals are devoting plenty of resources to the logistics of how they are going to comply with new federal price transparency requirements. There also are important ethical implications.
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Consults Alone Do Not Give Full Ethics Picture: Much Work Goes Unacknowledged
Ethics services are finding that the number of consults requested does not tell the full story of their workload. Insiders share tips on how to quantify these duties.
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Analysis Details the Burdens
of Prior AuthorizationAdministrative hassles and confusion, along with delays and denials, push providers and patients alike to the brink.
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CMS Finalizes 2021 Physician Fee Schedule, Tinged with a Bit of Controversy
A budget neutrality provision leads industry groups to cry foul over Medicare cuts.
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Substance Abuse and Suicidal Ideation Commonly Coexist in ED Patients
Appropriate discharge planning, including tracking patients and measuring outcomes of follow-up tactics, is a key aspect of the emergency management of this population.
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Pediatric Psych Visits Surging in EDs, Along with Medical Malpractice Risks
Before pediatric psychiatric patients are discharged from the ED, carefully document the visit and create a follow-up plan with a primary care physician or mental health professional. For patients presenting with suicidal ideation, a social worker or mental health clinician should develop a safety plan.
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Scripting Keeps Financial Message Consistent
Giving families a point of contact for each area of the revenue cycle is the best way to provide uniformity. For example, when patients call in for an explanation of their bills, connect them with customer relations. If they need to set up a payment plan, bring in financial counselors.
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Incomplete ED Registrations Disastrous for Copay Collections
Hospitals are trying to shorten door-to-provider times. Lower-acuity patients are treated as “fast-track,” and discharged quickly. Registration teams might struggle to keep up, to the point that some patients may miss the official registration process. Without proper contact information, collection becomes exponentially more difficult.
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Revenue Cycle Needs Prep Work for Tough Financial Conversations
The most challenging situation can be when patients ask why the cost is so high. Scripting can help registrars answer this difficult question. This training includes teaching patient access staff how to show the patient detailed benefits and explain the out-of-pocket expense is based on their insurance carrier.
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Health Plans Want Proof It Was Necessary to Admit Patient
Work with utilization managers to understand why these denials are happening. Ensure clinical documentation is detailed enough to support inpatient level of care, and be sure to submit such evidence to the health plan while patients still are in house.