Download or read book The Utilization Review Handbook written by Nancy Berry and published by . This book was released on 1982 with total page 160 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 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 Utilization Review written by American Medical Association. Committee on Medical Facilities and published by . This book was released on 1965 with total page 116 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 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 Utilization Review written by American Medical Association and published by . This book was released on 1968 with total page 128 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 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 Utilization Management written by American Psychiatric Association. Committee on Managed Care and published by American Psychiatric Pub. This book was released on 1992-01-01 with total page 84 pages. Available in PDF, EPUB and Kindle. Book excerpt: This handbook provides clinicians with timely and useful information that will help psychiatrists obtain optimal coverage of services for patients. Among the issues addressed are frequently encountered problems, confidentiality, contracting, and the process of utilization management.
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 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 Coordinator written by National Learning Corporation and published by Passbooks. This book was released on 2019-02 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Utilization Review Coordinator Passbook(R) prepares you for your test by allowing you to take practice exams in the subjects you need to study. It provides hundreds of questions and answers in the areas that will likely be covered on your upcoming exam, including but not limited to: evaluating health care; medical, psychiatric, developmental conditions and treatments; understanding and interpreting written material; and more.
Download or read book Concurrent Utilization Review Manual for Review Coordinators and Physician Reviewers written by Joanne Lamprey and published by . This book was released on 1978 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Utilization Management Guide written by David Ed Reiter and published by Urac. This book was released on 2005-01-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
