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Targeted Rounds Reduce PICU CAUTIs to Zero
Children’s Hospital of Philadelphia has achieved a rate of zero catheter-associated urinary tract infections through the use of daily targeted rounds. The hospital has maintained that zero rate for more than one year.
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Late Career Credentialing Policy Addresses Physicians Age 75 Years and Older
The following bullet points contain more information about the late career practitioner policy that has been instituted at Sinai Hospital of Baltimore.
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EEOC Sues Hospital for Mandatory Exams for Employees at Age 70 Years
A lawsuit filed by the U.S. Equal Employment Opportunity Commission alleges one facility's late career practitioner policy is illegal because it singles out individuals for testing based only on their age, not any suspicion about a decline in cognitive or physical abilities.
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Aging Physicians May Require Additional Assessments for Credentialing
There is no mandatory retirement age for physicians, but there is good reason to consider how aging may affect their abilities to safely and effectively practice medicine, especially for surgeons. Some healthcare organizations are addressing those concerns with programs that provide additional monitoring and testing for physicians as they age.
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Doctor Wins Defamation Suit Alleging Improper Peer Review Process
Responding to allegations of physician misbehavior is a challenge. A recent court case holds lessons for what can go wrong when a hospital does not follow best practices or even its own internal policies.
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Automating Auths: Not as Simple as It Sounds
If electronic prior authorization was implemented fully across the industry, the extra hours of work and high costs could be reduced significantly.
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When It Is Life and Death, No Time to Wait for Authorization
Denied claims for urgent, medically necessary procedures are no laughing matter. Patient access staff have to appeal each denial, a time-consuming and expensive process. A New York law states that if a patient presents with unexpected complications or requires additional services in the course of treatment, a health insurer will no longer be able to deny payment due to lack of prior authorization.
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The Pushback to Burdensome Authorization Requirements Has Begun
It is hard to dispute the fact that prior authorization requirements place a heavy burden on both patients and providers. Yet the number of services and medications requiring auths continues to increase. Read on to learn about several trends.
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Patient Care Goes Forward as Planned: ‘You’re Good to Go’
Patients tend to become anxious when scheduled care is cancelled due to authorization holdups. This happened so often in one system that a decision was made to change the process. If the payer takes too long to give an answer one way or the other, things go forward as planned anyway.
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Automation, Artificial Intelligence Future of Patient Access Authorizations
A revenue cycle operator explains how his department is breaking free from old-fashioned practices and moving toward automation.