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Case managers sometimes are confused as to what constitutes a business associate as referred to in the Health Insurance Portability and Accountability Act (HIPAA), notes Cathy Kauffman-Nearhoof, RN, BSN, CCM, NMCC, CLNC, owner of Integrist Healthcare Consulting in Duncansville, PA.
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Even with their dependence on health maintenance organizations (HMOs), many of the nations elderly suffer from a lack of coordinated care, are often confused about their treatment including proper use of medications and frequently end up in the hospital for lack of proper preventive measures.
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Ttwo frequently asked questions from the Department of Health and Human Services HIPAA web site that specifically address the types of communication that case managers and discharge planners engage in.
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A study by Irvine, CA-based Cogent Healthcare Inc. has confirmed what many case managers know instinctively: Following discharge from the hospital, many patients are confused about their medication, their discharge instructions, and when to follow up with their primary care physicians.
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When a child is referred to the special needs program at the Childrens Hospital of Wisconsin, a multidisciplinary team assesses the case and decides where the family can get the help it needs. Childrens Hospital is a 222-bed tertiary care facility with multiple specialty clinics and a teaching hospital affiliated with Medical College of Wisconsin in Milwaukee.
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A typical day for Deb Jablonski, RN, CCM, may include going to visit a specialist with the family of a medically complex child; working with the inpatient case managers and treatment team at the hospital to coordinate the care of a hospitalized child; talking with a school therapist about the care a child needs; or communicating with the childs pediatrician.
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Although the approach differs from surveyor to surveyor, same-day surgery programs that recently have undergone accreditation surveys notice that surveyors are more interactive with staff and less reliant on policies.
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Death or injury is 10 times more likely to occur in a doctors office than at outpatient clinics, according to a just-published review of surgeries performed in U.S. doctors offices.
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Beginning Oct. 16, providers, with a few exceptions, are required to submit all Medicare claims electronically. The Centers for Medicare & Medicaid Services (CMS) has distributed guidance on how to comply with transactions and code sets for the Health Insurance Portability and Accountability Act (HIPAA).
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The Centers for Medicare & Medicaid Services (CMS) has published proposed payment rates for hospital outpatient services, effective Jan. 1, 2004, and new rates for ambulatory surgery centers (ASCs), effective Oct. 1, 2003.