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If a patient gives untruthful information to registrars to avoid paying for services, this fraud can result in dangerous clinical outcomes as well as lost revenue.
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It is expected that metrics will be available so that the contributions of case management are quantified, as outlined by Toni Cesta, PhD, RN, FAAN, senior vice president, Lutheran Medical Center, Brooklyn, NY, in her April 2011 Case Management Insider article "You're only as good as yesterday's discharges Strategies to demonstrate case management's value."
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The devil is in the details when it comes to convening a successful interdisciplinary meeting.
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To maintain stability and effectiveness in meetings, the following steps should be considered.
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It's a new era for hospitals and for case managers as a multitude of auditors from the Centers for Medicare and Medicaid Services (CMS) and commercial payers scrutinize patient records looking for errors.
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Some states have highly developed quality improvement organizations (QIOs) that have for years worked with healthcare organizations to improve quality, share information, and tackle problems.
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Mention the U.S. Department of Veterans Affairs (VA) hospital system to QI professionals and you'll likely hear about any of the dozens of projects and programs developed at the VA that have percolated throughout the country and beyond with great positive impact on patients.
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Failure and near-misses offer a significant opportunity to change the way you do something in a way that will benefit patients. But is there a best method of doing a root-cause analysis (RCA)? According to St. Joseph's Hospital in St. Paul, yes.
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For some organizations, finding out where you fit in compared to other organizations is something they do regularly and well.
