Hospital Utilization Review Manual

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The Hospital Guide to Contemporary Utilization Review

Author : Stefani Daniels
Publisher :
ISBN 13 : 9781556452147
Total Pages : 0 pages
Book Rating : 4.4/5 (521 download)

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Book Synopsis The Hospital Guide to Contemporary Utilization Review by : Stefani Daniels

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

The Hospital Case Management Orientation Manual

Author : Peggy Rossi, Bsn, Mpa, CCM
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781615692910
Total Pages : 0 pages
Book Rating : 4.6/5 (929 download)

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Book Synopsis The Hospital Case Management Orientation Manual by : Peggy Rossi, Bsn, Mpa, CCM

Download or read book The Hospital Case Management Orientation Manual written by Peggy Rossi, Bsn, Mpa, CCM and published by Hcpro, a Division of Simplify Compliance. This book was released on 2014-06-12 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Case Management Orientation Manual Guide is a comprehensive resource that supplements of initial training for new case managers. This book explains what to document, where to document it to ensure appropriate level of care and reimbursement, and how to avoid unnecessary denials. This book's focus is utilization management, discharge planning, and relevant CMS regulations. It can help new case managers learn how to perform their jobs effectively on their own time. It can also serve as a wide-ranging resource for more experienced case managers, particularly those whose training was less than adequate.

Hospital Utilization Review and Medicare

Author : Rona Beth Schumer
Publisher :
ISBN 13 :
Total Pages : 130 pages
Book Rating : 4.3/5 (129 download)

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Book Synopsis Hospital Utilization Review and Medicare by : Rona Beth Schumer

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:

Managed Care Pharmacy Practice

Author : Navarro
Publisher : Jones & Bartlett Publishers
ISBN 13 : 076378883X
Total Pages : 659 pages
Book Rating : 4.7/5 (637 download)

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Book Synopsis Managed Care Pharmacy Practice by : Navarro

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.

The Leader's Guide to Hospital Case Management

Author : Stefani Daniels
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780763733544
Total Pages : 356 pages
Book Rating : 4.7/5 (335 download)

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Book Synopsis The Leader's Guide to Hospital Case Management by : Stefani Daniels

Download or read book The Leader's Guide to Hospital Case Management written by Stefani Daniels and published by Jones & Bartlett Learning. This book was released on 2005 with total page 356 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text will address the role of the hospital case manager from a busniess perspective rather than a nursing perspective. Will engage all areas that are involved with the health care system, in pursuit of global objectives on behalf of every stakeholder.

Drug Utilization Research

Author : Monique Elseviers
Publisher : John Wiley & Sons
ISBN 13 : 1118949781
Total Pages : 548 pages
Book Rating : 4.1/5 (189 download)

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Book Synopsis Drug Utilization Research by : Monique Elseviers

Download or read book Drug Utilization Research written by Monique Elseviers and published by John Wiley & Sons. This book was released on 2016-05-31 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug Utilization Research (DUR) is an eclectic scientific discipline, integrating descriptive and analytical methods for the quantification, understanding and evaluation of the processes of prescribing, dispensing and consumption of medicines and for the testing of interventions to enhance the quality of these processes. The discipline is closely related and linked mainly to the broader field of pharmacoepidemiology, but also to health outcomes research, pharmacovigilance and health economics. Drug Utilization Research is a unique, practical guide to the assessment and evaluation of prescribing practices and to interventions to improve the use of medicines in populations. Edited by an international expert team from the International Society for Pharmacoepidemiology (ISPE), DUR is the only title to cover both the methodology and applications of drug utilization research and covers areas such as health policy, specific populations, therapeutics and adherence.

The CMS Hospital Conditions of Participation and Interpretive Guidelines

Author :
Publisher :
ISBN 13 : 9781683086857
Total Pages : 546 pages
Book Rating : 4.0/5 (868 download)

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Book Synopsis The CMS Hospital Conditions of Participation and Interpretive Guidelines by :

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.

Registries for Evaluating Patient Outcomes

Author : Agency for Healthcare Research and Quality/AHRQ
Publisher : Government Printing Office
ISBN 13 : 1587634333
Total Pages : 385 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Registries for Evaluating Patient Outcomes by : Agency for Healthcare Research and Quality/AHRQ

Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Conditions of Participation for Hospitals

Author : United States. Social Security Administration
Publisher :
ISBN 13 :
Total Pages : 72 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Conditions of Participation for Hospitals by : United States. Social Security Administration

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 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Health-Care Utilization as a Proxy in Disability Determination

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

Author : OECD
Publisher : OECD Publishing
ISBN 13 : 9264805907
Total Pages : 447 pages
Book Rating : 4.2/5 (648 download)

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Book Synopsis Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies by : OECD

Download or read book Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Medicare Hospice Manual

Author :
Publisher :
ISBN 13 :
Total Pages : 176 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Medicare Hospice Manual by :

Download or read book Medicare Hospice Manual written by and published by . This book was released on 1992 with total page 176 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Hospital and Healthcare Security

Author : Tony W York
Publisher : Butterworth-Heinemann
ISBN 13 : 0080886027
Total Pages : 760 pages
Book Rating : 4.0/5 (88 download)

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Book Synopsis Hospital and Healthcare Security by : Tony W York

Download or read book Hospital and Healthcare Security written by Tony W York and published by Butterworth-Heinemann. This book was released on 2009-10-12 with total page 760 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospital and Healthcare Security, Fifth Edition, examines the issues inherent to healthcare and hospital security, including licensing, regulatory requirements, litigation, and accreditation standards. Building on the solid foundation laid down in the first four editions, the book looks at the changes that have occurred in healthcare security since the last edition was published in 2001. It consists of 25 chapters and presents examples from Canada, the UK, and the United States. It first provides an overview of the healthcare environment, including categories of healthcare, types of hospitals, the nonhospital side of healthcare, and the different stakeholders. It then describes basic healthcare security risks/vulnerabilities and offers tips on security management planning. The book also discusses security department organization and staffing, management and supervision of the security force, training of security personnel, security force deployment and patrol activities, employee involvement and awareness of security issues, implementation of physical security safeguards, parking control and security, and emergency preparedness. Healthcare security practitioners and hospital administrators will find this book invaluable. - Practical support for healthcare security professionals, including operationally proven policies, and procedures - Specific assistance in preparing plans and materials tailored to healthcare security programs - Summary tables and sample forms bring together key data, facilitating ROI discussions with administrators and other departments - General principles clearly laid out so readers can apply the industry standards most appropriate to their own environment NEW TO THIS EDITION: - Quick-start section for hospital administrators who need an overview of security issues and best practices

Analysis of Hospital Costs

Author : Donald S. Shepard
Publisher : World Health Organization
ISBN 13 : 9789241545280
Total Pages : 106 pages
Book Rating : 4.5/5 (452 download)

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Book Synopsis Analysis of Hospital Costs by : Donald S. Shepard

Download or read book Analysis of Hospital Costs written by Donald S. Shepard and published by World Health Organization. This book was released on 2000 with total page 106 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical guide to the principles and methods of cost analysis as a managerial tool for improving the efficiency of hospitals. Addressed to managers and administrators, the manual aims to equip its readers with the knowledge and skills needed to calculate the costs of different activities or departments, analyse their significance, and use this information to manage resources wisely. Throughout, recommendations and advice are specific to the different purposes of cost analysis and the different types of decisions commonly facing managers. The manual, which is intended for use as a training tool, was finalized following extensive field testing in workshops in Bangladesh, Egypt, and Zimbabwe. Methods of cost-finding and cost analysis are thoroughly explained and illustrated with practical examples and model step-by-step procedures for performing calculations. Since hospital accounting systems in developing countries may have gaps or inaccuracies, the manual gives particular attention to reliable methods for estimating costs when existing data are problematic. The manual opens with an explanation of the many advantages of using cost-finding and cost analysis as managerial tools. These include the provision of data needed for informed decisions on operations and infrastructure investment, the planning of future budgets, the establishment of charges for patient services, and the development of mechanisms for ensuring that costs do not exceed available revenues and subsidies. Against this background, the core of the manual is presented in three chapters. The first and most extensive chapter explains how to allocate costs to cost centres and how to compute unit costs. Information and examples are presented according to seven steps. Each is discussed in terms of the types of data needed, how component cost items should be treated, and how costs can be computed in particular situations or cases. Practical examples are used to illustrate the types of questions addressed in cost analysis and the value of this information in guiding decisions. Chapter two explains how cost data can be used to improve the management of an individual hospital. Information is intended to guide decisions at both the cost centre, or department, level and the hospital level. Managerial tasks covered include budgeting, profitability, efficiency improvements, contracting outside services or producing in-house, and assessing fiscal solvency. Chapter three considers the use of cost data in managing national and regional hospital systems. Specific applications include improvements in the referral system, the appropriate use of different providers of services, and the comparison of similar hospitals to identify inefficiencies or sources of waste. The manual concludes with a series of practical exercises, followed by explanations of their answers.

Handbook of Healthcare Operations Management

Author : Brian T. Denton
Publisher : Springer Science & Business Media
ISBN 13 : 1461458854
Total Pages : 542 pages
Book Rating : 4.4/5 (614 download)

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Book Synopsis Handbook of Healthcare Operations Management by : Brian T. Denton

Download or read book Handbook of Healthcare Operations Management written by Brian T. Denton and published by Springer Science & Business Media. This book was released on 2013-02-28 with total page 542 pages. Available in PDF, EPUB and Kindle. Book excerpt: From the Preface: Collectively, the chapters in this book address application domains including inpatient and outpatient services, public health networks, supply chain management, and resource constrained settings in developing countries. Many of the chapters provide specific examples or case studies illustrating the applications of operations research methods across the globe, including Africa, Australia, Belgium, Canada, the United Kingdom, and the United States. Chapters 1-4 review operations research methods that are most commonly applied to health care operations management including: queuing, simulation, and mathematical programming. Chapters 5-7 address challenges related to inpatient services in hospitals such as surgery, intensive care units, and hospital wards. Chapters 8-10 cover outpatient services, the fastest growing part of many health systems, and describe operations research models for primary and specialty care services, and how to plan for patient no-shows. Chapters 12 – 16 cover topics related to the broader integration of health services in the context of public health, including optimizing the location of emergency vehicles, planning for mass vaccination events, and the coordination among different parts of a health system. Chapters 17-18 address supply chain management within hospitals, with a focus on pharmaceutical supply management, and the challenges of managing inventory for nursing units. Finally, Chapters 19-20 provide examples of important and emerging research in the realm of humanitarian logistics.

Evidence-Based Practice Manual

Author : Albert R. Roberts
Publisher : Oxford University Press
ISBN 13 : 0198036922
Total Pages : 1079 pages
Book Rating : 4.1/5 (98 download)

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Book Synopsis Evidence-Based Practice Manual by : Albert R. Roberts

Download or read book Evidence-Based Practice Manual written by Albert R. Roberts and published by Oxford University Press. This book was released on 2004-01-15 with total page 1079 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Evidence-Based Practice Manual was developed as an all-inclusive and comprehensive practical desktop resource. It includes 104 original chapters, each specially written by the most prominent and experienced medical, public health, psychology, social work, criminal justice, and public policy practitioners, researchers, and professors in the United States and Canada. This book is specifically designed with practitioners in mind, providing at-a-glance overviews and direct application chapters. This is the only interdisciplinary volume available for locating and applying evidence-based assessment measures, treatment plans, and interventions. Particular attention has been given to providing practice guidelines and exemplars of evidence-based practice and practice-based research. The Evidence-Based Practice Manual emphasizes and summarizes key elements, issues, concepts, and how-to approaches in the development and application of evidence-based practice. Discussions include program evaluation, quality and operational improvement strategies, research grant applications, validating measurement tools, and utilizing statistical procedures. Concise summaries of the substantive evidence gained from methodologically rigorous quantitative and qualitative research provide make this is an accessible resource for a broad range of practitioners facing the mandate of evidence-based practice in the health and human services.

Hospital Manual

Author : United States. Social Security Administration
Publisher :
ISBN 13 :
Total Pages : 132 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Hospital Manual by : United States. Social Security Administration

Download or read book Hospital Manual written by United States. Social Security Administration and published by . This book was released on 1967 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Macquarie Dictionary of Trees and Shrubs is a comprehensive listing of the plants found in Australian gardens, including native trees, shrubs and climbers, as well as those introduced from other parts of the world. The entries are arranged in simple alphabetical order, under both the botanical and common names. Each plant is fully and clearly described with all relevant botanical information, together with gardening tips and much to interest the general reader. The back section of the book contains The Grower's Guide, a chart that allows you to select plants for your garden on the basis of particular features and growing conditions such as size, colour of flowers, specific uses, soil type, etc. The Macquarie Dictionary of Trees and Shrubs has been written specially for Australian conditions. It is the ideal reference for the Australian gardener looking to learn about everything from the Eucalyptus rubida to the Magnolia campbellii to the Rhododendron (azalea).