Download or read book Mastering Utilization Review written by Lauro Amezcua Patino Fapa, MD and published by Independently Published. This book was released on 2023-08-13 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization review is a pivotal process in inpatient psychiatry for adolescents and adults, playing a critical role in evaluating the necessity, appropriateness, and efficiency of healthcare services. This book offers physicians a comprehensive insight into utilization review, connecting healthcare providers and insurance companies. Key areas covered include medical necessity, treatment planning, length of stay, and navigating appeals and denials. By mastering these aspects, physicians can ensure optimal patient care while safeguarding against unnecessary treatments, thus enhancing the financial stability of their practice.The detailed guidance within the book covers how to effectively document medical necessity, develop evidence-based treatment plans tailored to each patient's needs, and strategize the length of stay based on clinical indicators. Additionally, it provides a roadmap for successful appeals in case of denials. This knowledge is crucial for physicians to optimize insurance coverage and reimbursement, avoiding premature discharges, and subsequent denials.In sum, the book serves as a vital tool for inpatient psychiatric practitioners, offering the knowledge and tools necessary to navigate the complex landscape of utilization review. It strikes a careful balance between patient needs, ethical treatment, and financial considerations, ensuring that the right care is provided without excess, and contributes significantly to the broader discourse on healthcare efficiency and responsibility.
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 Utilization Review written by National League for Nursing. Committee to Study Utilization Review Process and published by . This book was released on 1973 with total page 25 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Mastering Medical Coding E Book written by Marsha Diamond and published by Elsevier Health Sciences. This book was released on 2006-06-02 with total page 841 pages. Available in PDF, EPUB and Kindle. Book excerpt: Expansion of ICD-9-CM information. - Sample patient charts include explanatory notes. - A simulated medical practice (identified as Godfrey Regional) lets you study in a real-world scenario. - Key Terms lists highlight the most important vocabulary and content. - More exercises!
Download or read book Utilization Review written by United States. General Accounting Office and published by . This book was released on 1992 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Mastering Evaluation and Management Services in Healthcare written by Stacy Swartz and published by Business Expert Press. This book was released on 2020-12-08 with total page 85 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explores Evaluation and Management (E/M) coding and serves as a resource in the practice and application of level of service codes. For two decades the 1995 and 1997 guidelines have provided guidance and structure around the documentation requirements necessary to support professional, outpatient services. After twenty-three years, Medicare has announced the adoption of a new set of standards to be released on January 1, 2021. This book will serve as a guide for correct code assignment and as an educational resource for the 1995, 1997 and 2021 documentation guidelines.
Download or read book Mastering Documentation written by Springhouse Corporation and published by . This book was released on 1995 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt: The complete guide for streamlining and improving nursing documentation for virtually every system. Nurses will find instructions for virtually every common and not-so-common charting method. From progress notes to protocols, there is a wealth of easy-to-follow examples throughout the book. Includes JCAHO-approved nursing abbreviations, ANA standards of practive, and JCAHO and Medicare guidelines for nursing documentation.
Download or read book Utilization Review Some Directions written by Council of Home Health Agencies and Community Health Services. Committee to Study Utilization Review Process and published by . This book was released on 1973 with total page 25 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Mastering Changing Through Creative Leadership written by and published by . This book was released on 1992 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Clinician s Guide to Partial Hospitalization and Intensive Outpatient Practice written by Dr. David Houvenagle, PhD, LCSW and published by Springer Publishing Company. This book was released on 2015-06-04 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt: Print+CourseSmart
Download or read book Utilization Review written by U. S. Government Accountability Office ( and published by BiblioGov. This book was released on 2013-06 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pursuant to a congressional request, GAO reviewed utilization review organizations (URO), focusing on: (1) the size and ownership of URO; (2) the professional qualifications of staff involved in utilization review decisions; (3) the complexity of decisions made by various staff; (4) appeal procedures; (5) clinical review criteria used by URO; and (6) quality assurance procedures implemented to ensure adherence to company directives. GAO found that: (1) physicians are usually employed by URO on a part-time basis or as consultants/advisors; (2) registered nurses are heavily involved in first-level review decisions, but physicians become more involved during the second-level review and appeal process; (3) URO generally used commercially developed review criteria when making recommendations; (4) most URO have established appeal procedures; (5) of the few utilization decisions that are appealed, many are successful; (6) URO have implemented quality assurance procedures to ensure adherence to company directives; (7) in 1990, a commission was established to develop quality assurance standards for URO and to accredit organizations that seek this distinction; (8) many URO set minimum qualifications and education levels for clinical and nonclinical staff; and (9) URO activities included prehospital admission certification review, concurrent reviews, second surgical opinions, and case management.
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 Mastering Records Completion written by and published by . This book was released on 1998 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Mastering Information Security Compliance Management written by Adarsh Nair and published by Packt Publishing Ltd. This book was released on 2023-08-11 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: Strengthen your ability to implement, assess, evaluate, and enhance the effectiveness of information security controls based on ISO/IEC 27001/27002:2022 standards Purchase of the print or Kindle book includes a free PDF eBook Key Features Familiarize yourself with the clauses and control references of ISO/IEC 27001:2022 Define and implement an information security management system aligned with ISO/IEC 27001/27002:2022 Conduct management system audits to evaluate their effectiveness and adherence to ISO/IEC 27001/27002:2022 Book DescriptionISO 27001 and ISO 27002 are globally recognized standards for information security management systems (ISMSs), providing a robust framework for information protection that can be adapted to all organization types and sizes. Organizations with significant exposure to information-security–related risks are increasingly choosing to implement an ISMS that complies with ISO 27001. This book will help you understand the process of getting your organization's information security management system certified by an accredited certification body. The book begins by introducing you to the standards, and then takes you through different principles and terminologies. Once you completely understand these standards, you’ll explore their execution, wherein you find out how to implement these standards in different sizes of organizations. The chapters also include case studies to enable you to understand how you can implement the standards in your organization. Finally, you’ll get to grips with the auditing process, planning, techniques, and reporting and learn to audit for ISO 27001. By the end of this book, you’ll have gained a clear understanding of ISO 27001/27002 and be ready to successfully implement and audit for these standards.What you will learn Develop a strong understanding of the core principles underlying information security Gain insights into the interpretation of control requirements in the ISO 27001/27002:2022 standard Understand the various components of ISMS with practical examples and case studies Explore risk management strategies and techniques Develop an audit plan that outlines the scope, objectives, and schedule of the audit Explore real-world case studies that illustrate successful implementation approaches Who this book is forThis book is for information security professionals, including information security managers, consultants, auditors, officers, risk specialists, business owners, and individuals responsible for implementing, auditing, and administering information security management systems. Basic knowledge of organization-level information security management, such as risk assessment, security controls, and auditing, will help you grasp the topics in this book easily.
Download or read book High Speed Railways and New Structure of Socio economic Development in China written by Xiaoyan Lin and published by Springer Nature. This book was released on 2023-06-14 with total page 346 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book systematically expounds the significance of the high-speed railway in China's regional economic and social development. It also contains a large number of case discussions, so that readers can fully understand the development of China's high-speed railway and its role in promoting China's economy. The purpose of this book is to determine whether high-speed railway has important political and strategic significance for China's development, the inherent relationship and mechanism of the high-speed railway together with economic and social development, and how to achieve the high-speed rail and economic and social coordination, as well as sustainable development.
Download or read book Introduction to Utilization Review written by Nancy Berry and published by . This book was released on 1994 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Mastering Chronic Pain written by Robert N. Jamison and published by . This book was released on 1996 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Professional's Guide describes a structured, time-limited, and group-based pain program built on the principles of cognitive/behavioral therapy and rehabilitation. Includes many forms, illustrations, questionnaires, checklists, and letters which may be copied for use with your patients.
