Download or read book Hospital Utilization Review and Medicare written by Rona Beth Schumer and published by . This book was released on 1971 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 Controlling Costs and Changing Patient Care written by Institute of Medicine and published by National Academies Press. This book was released on 1989-02-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Download or read book An Evaluation of a Medicare Concurrent Utilization Review Project written by Maura Bluestone and published by . This book was released on 1978 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Hospital Utilization Review and Medicare written by Rona Beth Schumer and published by . This book was released on 1973 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Conditions of Participation for Hospitals written by United States. Social Security Administration and published by . This book was released on 1966 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare written by and published by . This book was released on 1968 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Hospital Utilization Review and Medicare written by and published by . This book was released on 1972 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Health Insurance for the Aged written by and published by . This book was released on 1966 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare written by Institute of Medicine and published by National Academies Press. This book was released on 1990-02-01 with total page 462 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of careâ€"how it is defined, measured, and improvedâ€"and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students.
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Download or read book Medicare and the Hospitals written by Herman Miles Somers and published by . This book was released on 1967 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The CMS Hospital Conditions of Participation and Interpretive Guidelines written by and published by . This book was released on 2017-11-27 with total page 546 pages. Available in PDF, EPUB and Kindle. Book excerpt: In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.
Download or read book A Framework for Developing a Medicare Patient Utilization Review Program at Northbay Healthcare Corporation Hospitals written by Rena B. David and published by . This book was released on 1988 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare written by Institute of Medicine and published by National Academies Press. This book was released on 1990-02-01 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Volume II of Medicare: A Strategy for Quality Assurance provides extensive source materials on quality assurance, including results of focus groups with the elderly and practicing physicians, findings from public hearings on quality of care for the elderly, and many exhibits from site visits and the literature on quality measurements and assurance tools. The current Medicare peer review organization program and related hospital accreditation efforts are comprehensively described as background for the recommendations in Volume I of this report. Like the companion volume, this substantial book will be a valuable reference document for all groups concerned with quality of health care and the elderly.
Download or read book Patient Status Training Toolkit for Utilization Review written by Kimberly Anderwood Hoy Baker and published by . This book was released on 2016-02 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Status Training Toolkit for Utilization Review Kimberly A.H. Baker, JD, CPC Toolkit contains 5 handbooks and 5 pocket cards. Make sense of medical necessity, condition codes, and patient notices while reviewing cases. ThePatient Status Training Toolkit for Utilization Review is a quick-reference handbook and pocket card that will serve as an everyday guide to utilization review (UR). The handbook is a practical guide that UR committee members can keep at their desk to refer to as they work through UR processes. It offers an overview of regulatory requirements for UR in addition to access to downloadable case studies and Medicare resources that can help guide committee members through real-world cases. The pocket card is an easy-to-digest reference that uses a flow chart and helpful tips to walk UR committee members through the process of verifying patient status determinations. If the or UR committee member reviews a case and determines the patient's status must be changed, the pocket card will offer guidance on this process through days one and two, if applicable.
Download or read book Ten Years of Short stay Hospital Utilization and Costs Under Medicare 1967 1976 written by Charles Helbing and published by . This book was released on 1980 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt:
