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It sounds fairly cut and dried: If an authorization isn't obtained from a payer, the claim will be denied. However, payer requirements are getting more and more complex and stringent.
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A series of initiatives at Central DuPage Hospital has helped decrease length of stay and improve patient flow, according to Corinne Haviley, RN, MS, associate chief nurse at the 313-bed hospital in Winfield, IL.
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By implementing a series of patient flow initiatives over a 10-month period, UC Health University Hospital, a 693-bed academic medical center in Cincinnati, was able to decrease the average patient length of stay by 5.34 hours, giving the hospital the ability to serve 1,300 more patients each year.
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As they wait to learn the next steps in health care reform, case managers should start thinking about what they need to do to get ready for the future, says Beverly Cunningham, RN, MS, vice president, clinical performance improvement, Medical City Dallas Hospital.
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As the Centers for Medicare & Medicaid Services and commercial payers move to base reimbursement on quality and consumers become more savvy about their choices of health care providers, complete and accurate documentation will become even more important.
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A young woman presented to the emergency department (ED) of a hospital after being shot in the head with an air pellet rifle. Almost half an hour passed between the time the woman was seen by the ED nurse and the time the nurse informed the ED physician of the woman's condition.
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Counts are an essential tool for reducing the number of retained items in surgery, but they should be augmented with other strategies, according to one recent study.
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The Joint Commission (TJC) is underscoring its commitment to keep accreditation records confidential and its willingness to resist prosecutors' requests as far as the law will allow.
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Avoiding the wrong phone number problem begins during the intake process...