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With payer requirements becoming more numerous, patient access departments face an ongoing battle to keep staff current.
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Because the prior authorization process occurs well in advance of a service, your Patient access staff will need to be prepared for ICD-10 well before the Oct. 1, 2013, implementation date, warns Rennae J. Glidden, RHIT, director of data services at HealthEast Care System Midway Campus in St. Paul, MN. Use these strategies:
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Your current systems will need to be remediated if they will be used to check medical necessity for ICD-10 standards when they are implemented in October 2013, says Jeffrey Smith, RN, MBA, CPC, a New York City-based manager at Accenture Insight Driven Health, a management and technology consulting company.
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If employees don't trust you, they probably won't listen to your advice, agree to take a health risk assessment, or participate in your wellness programs.
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When a health plan, a physician network, and a hospital teamed up to reverse the trend of Medicare hospital readmissions within 30 days of discharge, readmissions dropped by 30% or more over an eight-month period when compared to the readmission rate in the same hospital the previous year.
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A resource library for patient education should contain DVDs to help visual learners understand information, according to Taryn J. Bailey, MSN, RN-BC, executive director of Professional Practice and Patient Education Services at North Shore Medical Center in Salem, MA.
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UnitedHealthcare's post-acute transition program has reduced the average length of stay in skilled nursing facilities by three to five days, depending on the market, for members in the program.
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To improve access to health care in Logan County, IL, the Healthy Communities Partnership was formed 13 years ago. The mission statement of the partners is "to improve the health and quality of life for people in the communities we serve." This is accomplished in many ways, but almost always, education is a key component.
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Healthy eating is a good target area for education, because people are confused about what healthy eating means, contends Andrea Giancoli, MPH, RD, an American Dietetic Association spokesperson who lives in Southern California.
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James L. Reinertsen, MD, received a 2010 John M. Eisenberg Patient Safety and Quality award for individual achievement from The Joint Commission and the National Quality Forum
