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 A Guide to Utilization Review written by Joanne Lamprey and published by . This book was released on 1991 with total page 192 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 Guide to Utilization Management written by Joanne Lamprey and published by . This book was released on 1987 with total page 177 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 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 The Comparative Guide to Hospital Utilization Review written by Warren Greenberg and published by . This book was released on 1986* with total page 59 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Utilization Review Guide written by and published by . This book was released on 2009 with total page 4 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medical treatment requiring prior authorization.

Download or read book Guide for the Utilization Review Coordinator in a Quality Assurance Program written by Hospital Research and Educational Trust. Center for Educational Innovation and published by . This book was released on 1974 with total page 17 pages. Available in PDF, EPUB and Kindle. Book excerpt:

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 Guide to Utilization Management written by Joanne Lamprey and published by . This book was released on 1989 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Guide to Utilization Review for Extended Care Facilities written by and published by . This book was released on 1967 with total page 27 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Utilization Review written by Richard E. Johnson and published by International Foundation of Employee benefit. This book was released on 1988 with total page 67 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Guide to Utilization Review for Psychiatric Hospitals written by and published by . This book was released on 1968 with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Research in Rehabilitation Counseling written by James L. Bellini and published by Charles C Thomas Publisher. This book was released on 2009 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: This second edition represents the thorough revision necessary to accurately reflect the variation and wealth of research methodologies used in contemporary rehabilitation counseling research. As with the previous edition, this new second edition is divided into ten chapters. Chapter 1 establishes the theoretical underpinnings of social scientific inquiry, provides a foundation in the philosophical, epistemological, and methodological considerations related to the design and execution of rehabilitation research, and discusses the broad purposes of research. Chapter 2 addresses the issues that are preparatory to designing and evaluating this research, the sources of research ideas, and translating these ideas into research hypothesis, identifying variables, and sampling issues. Chapter 3 discusses key measurement and statistical concepts used in the quantitative research tradition, including reliability and validity of measurements instruments, the purposes of descriptive and inferential statistics in analyzing numeric data, and provides an expanded section on methods of statistical analysis. Chapters 4 and 5 reviews ethical issues and guidelines for the design, implementation, and reporting of rehabilitation research, drawing valid inferences from results, and generalizing findings from the research sample to the target population. Chapters 6, 7, and 8 review the wide range of different quantitative, qualitative, and integrative approaches to doing rehabilitation research, and provides examples from the recent rehabilitation literature. Other topics include the intervention/stimulus relationship, descriptive studies in the quantitative paradigm, and qualitative methods of rehabilitation research. Chapter 9 presents a published research article section by section, annotates the components and composition of a research report, and provides a protocol that students and practitioners can use to evaluate the technical soundness and scientific merits of published research articles. The concluding chapter addresses future trends in rehabilitation counseling research in relation to fruitful topic areas and methodologies as they apply to counselors, administrators, policymakers, educators, researchers, people with disabilities, and consumer advocates. This book provides the 'basics' that one would need to begin conducting a research investigation.

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.