Download or read book The Hospital Guide to Contemporary Utilization Review written by Stefani Daniels and published by . This book was released on 2015-04-16 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives

Download or read book The Hospital Guide to Contemporary Utilization Review written by Stefani Daniels and published by . This book was released on 2018 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Hospital Guide to Contemporary Utilization Review Third Edition written by Stefani Daniels and published by . This book was released on 2021-10 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Guide to Contemporary Utilization Review, Third Edition, is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations in a value-based world. The book covers a range of topics, including compliance with the UR Conditions of Participation (CoP), legal obligations of a hospital, contract language, and compliant UR plan language, to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best-practice hospital UR program Describe the legal obligations of the hospital to comply with Chapter 42 CFR 482.30 of the CoP Use the publication as a tool to assess your own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Differentiate between traditional Medicare and Medicare Advantage Facilitate the development of a contemporary UR committee Discuss the pros and cons of the possible reporting structures for UR activities Examine the role of the physician advisor as a member of the UR team Recognize the crucial role of revenue cycle in the work of the UR specialist Recommend compliant language for your organization's UR plan Describe the components of the revenue cycle pertinent to UR Differentiate inpatient and outpatient payment rules Explain the basics of claim preparation Review physician billing and payment rules Differentiate between national coverage determinations, local coverage determinations, and commercial payer criteria Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good UR plan and a hospital's revenue cycle initiatives

Download or read book A Physician s Guide to Utilization Review written by Marshall R. Levine and published by F. A. Davis Company. This book was released on 1987 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medical Utilization Review Coordinator The Comprehensive Guide written by VIRUTI SHIVAN and published by Viruti Satyan Shivan. This book was released on with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the rapidly evolving landscape of healthcare, the role of a Medical Utilization Review Coordinator has never been more critical. This comprehensive guide is designed to navigate you through the complexities of healthcare management, ensuring efficiency, compliance, and optimal patient care. Whether you're new to the field or looking to enhance your expertise, this book offers a treasure trove of insights, strategies, and best practices. By focusing on the intersection of medical necessity, patient rights, and regulatory requirements, it prepares you to become an invaluable asset to any healthcare organization. Without relying on images or illustrations, this guide delves deep into the core responsibilities of a Medical Utilization Review Coordinator, from conducting thorough patient case reviews to navigating insurance verifications and appeals. It emphasizes the importance of evidence-based decisions, interdisciplinary collaboration, and ethical patient advocacy. This book stands out by offering real-world scenarios, expert advice, and actionable tips to excel in this demanding yet rewarding career. As the healthcare industry continues to face unprecedented challenges, equip yourself with the knowledge and skills to make a significant impact on the quality and efficiency of care provided.

Download or read book A Study Guide in Quality Assurance and Utilization Review written by Robert B. Tobias and published by . This book was released on 1986 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Physician s Guide to the Business of Medicine written by Jeffrey T. Gorke and published by Greenbranch Pub Llc. This book was released on 2010-01-01 with total page 155 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nationally known healthcare consultant Jeffrey Gorke translates his 20 years of experience into a winning playbook for joining, starting or running a "dream" practice. Packed with tips, insights and action-oriented tools, this fast-paced guide helps readers rapidly master the language, players, management structures and culture issues and use what they've learned to ask all the right questions in identifying, seeking and landing the absolute best job. Learn how to size up location, compensation, work-life balance, and the freedom to practice medicine! NOTEWORTHY FEATURES - A comprehensive, step-by-step check list makes sure you cover every question in the practice-selection process and lets you do revealing side-by-side comparisons of all the practices under consideration. - Practical tips and reality checkpoints on what to expect in the private practice setting. - Instant financial mastery: Spreadsheets and graphical presentations make it easy for readers to evaluate business and financial data to learn what's really happening in a practice — and what questions you'll need to keep asking if you decide to join. - Clear action steps: How to evaluate factors such as a practice's location or culture and what plusses and minuses to look for in terms of managers, consultants, and business structure. - And a Bonus! Illustrative real-life anecdotes from the medical practice trenches.

Download or read book The Physician s Guide to Managed Care written by David B. Nash and published by Jones & Bartlett Learning. This book was released on 1994 with total page 280 pages. Available in PDF, EPUB and Kindle. Book excerpt: You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.

Download or read book Optimizing the Physician Advisor in Case Management written by Mark S. Michelman and published by HC Pro, Inc.. This book was released on 2008-11 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt: Foster effective relationships between case management and physicians with a strong physician advisor program. With increasing federal compliance regulations, there has never been a greater need to have a physician advisor (PA) on staff to provide your case management team with more support to achieve your organizational goals. Whether you're building a new PA program or want to revitalize an existing one, the new HCPro book Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results delivers the guidance you need to improve the chain of communication across the continuum of care. Written by Mark Michelman, MD, MBA, Sharon Mass, PhD, LCSW, ACM, and Donna Ukanowicz, MS, RN, ACM, the book combines the perspectives of a physician advisor, nursing case manager, and social work case manager. The book is the industry's first resource that provides: Easy-to-follow steps to create or revamp your program Tips to recruit and train PAs Strategies for defining measurable goals and effective PA responsibilities Analysis methods for evaluating need and justifying resources Metrics to measure your success A CD-ROM loaded with adaptable tools and forms

Download or read book Physician Assistant Review Guide written by David Paulk and published by Jones & Bartlett Publishers. This book was released on 2009-04-24 with total page 509 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physician Assistant Review Guide is a comprehensive overview for physician assistants preparing for the Physician Assistant National Certifying (PANCE) or Re-certifying exam (PANRE). This guide extensively covers every topic PAs need to know, including cardiology, dermatology, emergency medicine, infectious diseases, neurology, oncology, pediatrics, women's health, and more. Also features a straightforward question format with questions designed for both new graduates and practicing clinicians, as well as test-taking strategies, detailed illustrations and photographs, explanations to the answers with accompanying artwork, and clear connections between the best evidence-based clinical practice and subject matter testing. FEATURES Ideal review for the PANCE and PANRE exams Over 1088 questions included in the content review chapters FULL color photos and images for great reader comprehension Detailed answer rationales Test-taking strategies Organized by body systems, each chapter is written and peer reviewed by subject experts for the most up-to-date information connecting evidence-based clinical practice with exam review. Please note: Electronic formats of this review guide do not include the CD ROM.

Download or read book Information to Guide Physician Practice written by and published by . This book was released on 1996 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Physician Assistant A Guide to Clinical Practice written by Ruth Ballweg and published by Elsevier Health Sciences. This book was released on 2017-02-20 with total page 761 pages. Available in PDF, EPUB and Kindle. Book excerpt: Entering its 6th edition, Physician Assistant: A Guide to Clinical Practice is the only text that covers all aspects of the physician assistant profession, the PA curriculum, and the PA's role in clinical practice. It is designed as a highly visual and practical resource to be used across the spectrum of lifelong learning, enabling students and practicing PAs to thrive in a rapidly changing health care system. - Teaches how to prepare for each core clinical rotation and common electives, as well as how to work with atypical patient populations such as homeless patients and patients with disabilities. - A succinct, bulleted writing style; convenient tables; practical case studies; and clinical application questions throughout enable you to master key concepts and clinical applications. - Helps you master all the core competencies needed for certification or recertification. - Addresses all six Physician Assistant Competencies, as well as providing guidance for the newly graduated PA entering practice. - Includes quick-use resources, such as objectives and key points sections for each chapter, tip boxes with useful advice, abundant tables and images, and 134 updated case studies. - Features chapters for the 7 core clinical rotations and 5 common electives, with key guidance on how to prepare effectively and what to expect. - Provides updated health policy information, expanded information about international programs, cultural competencies, and pearls and pitfalls on working internationally as a PA. - Outlines the basic principles of Interprofessional Education – an important new trend in medical education nationally. - New chapters cover: Maximizing Your Education, Future of the Profession, Principles of PA Education, Managing Stress and Burnout, and many other topics. - Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, and references from the book on a variety of devices.

Download or read book Adverse Events Stress and Litigation written by Sara C. Charles M.D. and published by Oxford University Press. This book was released on 2005-04-14 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: What is it like to be sued for medical malpractice? Bad medical outcomes traumatize patients but they also traumatize physicians. The litigation that often follows is a profoundly human, rather than just a legal experience. Although every physician's case is different, this book shows how each case goes through the same judicial stages of complaint, discovery, depositions, motions, and delays that lead to trial, settlement, or being dropped. It also gives doctors an understanding of how lawyers think and work to help defendants. Written by a physician and a lawyer, the book provides unique insights - through real-life stories - into the personal experience of litigation as well as recommendations for dealing with each of the legal process. It also includes up-to-date reviews of HIPAA legislation, the controversial subject of disclosure, and recent developments in the law affecting medical practitioners. Only about thirty percent of plaintiffs win their cases against doctors, but the journey from bedside to witness stand tests both the personal character and the professional skills of those accused. This well-documented book will help doctors understand and navigate the legal system while honoring their own ideals and emerging changed but stronger from the experience.

Download or read book The Physician s Guide to Personal Finance written by Jeff Steiner and published by . This book was released on 2013-08-10 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: An outline review of personal finance for physicians.

Download or read book Managed Care Pharmacy Practice written by Navarro and published by Jones & Bartlett Publishers. This book was released on 2008-12-11 with total page 659 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.

Download or read book Physician s Field Guide to Neuropsychology written by Karen M. Sanders and published by . This book was released on 2019 with total page 612 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique volume teaches those in the medical fields about the scientific value of neuropsychology in assessing cognition, the 6th vital sign, as part of well integrated collaborative care. It offers physicians a comprehensive tour of the many dimensions neuropsychology can add to primary and specialized medical care across the lifespan. Noted experts examine cognitive ramifications of a wide range of medical, psychological, and neuropsychological conditions, among them brain tumors, stroke, epilepsy, pediatric and adult TBI, schizophrenia, and adult ADHD. The books generous selection of case examples demonstrates the benefits of cognitive assessment in building accurate diagnoses, better understanding of patient needs, and more appropriate treatment and management strategies, as well as other neuropsychologist roles in consulting, referral, and forensic areas. In addition, tables, callout boxes, review questions, and other features are included throughout the text for ease in comprehension and retention. A sampling of the coverage: · The value of neuropsychological evaluation in medical practice. · A model of collaboration between primary care and neuropsychology. · Neuropsychological assessment of extremely preterm children. · Alzheimers Disease and overview of dementia. · Deep brain stimulation for Parkinsons Disease. · Neuropsychology in the 21st century: the rise of multicultural assessment. · Neuropsychological interventions for individuals with brain injury. The Physicians Field Guide to Neuropsychology is both a rigorous and an accessible reference for clinicians in diverse disciplines including general practice, family medicine, neuropsychology, pediatrics, gerontology, and sports medicine.

Download or read book The Physician Leader s Guide written by Richard Burton and published by Jones & Bartlett Learning. This book was released on 1997-12 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Physicians Leader's Guide, Second Edition was updated and expanded to help you and your staff define your challenges, organize your expa nding responsibilities and take your performance to new levels. Edited by Richard Burton MD, MBA, PhD, this time-saving resource includes 15 additional, all-new, skill-building chapters, to help you excel in yo ur leadership role. From developing effective negotiation skills as a physician...to handling information systems in clinical practice...to using medical practice guidelines and evidence-based medicine to impro ve care.. you'll see how your colleagues in the healthcare industry ma stered the very same challenges you face, and how you can do it too!