Hospital
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50% of denials are overturned
Reasons for denials include that the service is experimental, that the service did not meet medical necessity, or that the service required a prior authorization.
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How to Cut Registration Errors
Here's how access managers created a success story at Stanford Children’s Health.
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Payers want two weeks to review auth requests
As if there aren’t already enough roadblocks to obtaining authorizations, payers are now requiring unrealistic timeframes to review these requests.
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Tampa hospital reduces falls 16% in facility’s common areas with simple changes
After implementing several mostly simple safety initiatives, St. Joseph's Hospital in Tampa, FL, saw a 16% reduction in falls from the previous year.
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Crowded EDs leaving proven strategies for improving patient flow on the table
Despite the fact that ED crowding is associated with a range of concerning outcomes, including higher mortality rates, higher rates of complications, and increased errors, there is new evidence many EDs are leaving proven strategies for improvement in this area on the table.
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“Warm handoffs” can reduce hospitals’ readmission rates
Newton-Wellesley Hospital in Newton, MA, improved its readmission rates through a quality improvement process that included measurements of “warm handoff” rates.
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Case managers need to connect across continuum
Case managers working together across the care continuum can improve the problem of healthcare silos.
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Try some new strategies for motivating clients
Case managers can improve client motivation through strategies that include learning what is important to them and breaking up their overall goal into bite-sized steps.
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A glimpse inside the incubator: Creating new CM outcomes tool
Case management work increasingly is being measured, but the big issue is finding tools for effective measurement of CM outcomes.
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Nursing leader: Nurse-to-nurse hostility may go back to ancient competition for men
In a gender-loaded assessment that might be labeled sexist if stated by a man, a female nursing leader says the field’s “bullying” culture may have its roots in the ancient competition among women for male mates.