Hospital Management
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Online, Classroom, Team Huddles: For Training, All That (and More) Is Needed
The amount of needed education for patient access is only increasing. How can leaders help staff keep up?
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Optimizing COPD Discharge Planning
Patients are not one size fits all when discharged with COPD. However, in readmission rates they are all lumped together, one expert says.
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Some Patients Present With ‘Hidden’ Insurance Coverage; Patient Access Can Uncover It
Certain patients who say they do not have any insurance actually are covered in some way. It is the job of patient access staff to find it — and avoid uncompensated care for the hospital.
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Healthcare Facility Uses Lean Principles to Enact Systemwide Culture Change
A hospital’s process improvement (PI) could begin with a focus on reducing gaps in quality service. The Cleveland Clinic started such a process, focusing on engaging all employees in process improvement — rather than leaving the work to one PI team.
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Risk Assessment Tool Helps Identify People in Need of Case Management
The Valley Risk Assessment Tool, created by The Valley Hospital of Ridgewood, NJ, is a two-page, two-column chart that assigns a level to each category of risk.
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Payers, Hospitals Disagree About Whether Patient Meets Inpatient Criteria
Payers are refusing to pay claims for gastric bypass, joint replacement, and even cataract extraction. Why? Because documentation in the record does not support the need for surgery.
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Tips to Improve Quality and Efficiency in Case Management Departments
One of the first steps to streamline case management operations is to reassign staff to new roles, such as focused discharge planning jobs and utilization review.
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Missing Clinical Documentation Reason for Many Claims Denials
More health plans are asking for certain pieces of clinical documentation before paying claims. If it is not there, the claim is denied. What are the specific issues arising?
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Team-Based Case Management Improves Care Coordination
A health system’s focus on revamping its care coordination led to a reduction in some 30-day readmissions, as well as other benefits.
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More Patients Newly Eligible for Medicaid; Many Unaware
Medicaid has expanded in many states so previously uninsured patients can access coverage. However, many may not be aware they qualify. Learn how one health system helps eligible patients enroll.