The Hospital Guide to Contemporary Utilization Review

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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 Guide to Contemporary Utilization Review

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Publisher :
ISBN 13 : 9781683087144
Total Pages : 141 pages
Book Rating : 4.0/5 (871 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 2018 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Hospital Guide to Contemporary Utilization Review, Third Edition

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Publisher :
ISBN 13 : 9781645351382
Total Pages : 194 pages
Book Rating : 4.3/5 (513 download)

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

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

The Comparative Guide to Hospital Utilization Review

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Publisher :
ISBN 13 :
Total Pages : 59 pages
Book Rating : 4.:/5 (135 download)

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Book Synopsis The Comparative Guide to Hospital Utilization Review by : Warren Greenberg

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:

Utilization Management and Cost Control: A New Role for Hospital Utilization Review

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (863 download)

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Book Synopsis Utilization Management and Cost Control: A New Role for Hospital Utilization Review by : Robert Miller

Download or read book Utilization Management and Cost Control: A New Role for Hospital Utilization Review written by Robert Miller and published by . This book was released on 1990 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

A Guide to Utilization Review

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Publisher :
ISBN 13 :
Total Pages : 192 pages
Book Rating : 4.:/5 (243 download)

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Book Synopsis A Guide to Utilization Review by : Joanne Lamprey

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:

Hospital Utilization Review Manual

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Publisher :
ISBN 13 :
Total Pages : 234 pages
Book Rating : 4.:/5 (986 download)

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Book Synopsis Hospital Utilization Review Manual by : Michigan State Medical Society. Committee on Evaluation of Prepaid Medical Services

Download or read book Hospital Utilization Review Manual written by Michigan State Medical Society. Committee on Evaluation of Prepaid Medical Services and published by . This book was released on 1966 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:

CMSA Core Curriculum for Case Management

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Publisher : Lippincott Williams & Wilkins
ISBN 13 : 1496351894
Total Pages : 862 pages
Book Rating : 4.4/5 (963 download)

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Book Synopsis CMSA Core Curriculum for Case Management by : Hussein M. Tahan

Download or read book CMSA Core Curriculum for Case Management written by Hussein M. Tahan and published by Lippincott Williams & Wilkins. This book was released on 2016-07-05 with total page 862 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fully updated CMSA Core Curriculum for Case Management, 3rd edition, is the definitive roadmap to an informed, effective, collaborative case management practice. This comprehensive, expertly-written guide provides those directly or indirectly involved in case management with information about best practices, descriptions of key terms, essential skills, and tools that fulfill the current Case Management Society of America’s (CMSA) standards and requirements. Addressing the full spectrum of healthcare professional roles and environments, this is both a crucial certification study guide and vital clinical resource for the case management professionals in all specialty areas, from students to veteran case managers. This unique resource provides the core knowledge needed for safe, cost-effective case management with the following features ... NEW text boxes highlighting key information and vital practices in each chapter NEW and updated Standards of Practice implications in each chapter NEW and updated content on transitions of care, community-based care, care coordination, Value-Based Purchasing, ethics and social media, the impacts of health care reform, and digital technology NEW and updated content on accreditation in case management NEW chapter that lists key additional resources, by topic Official publication of the Case Management Society of America, connecting CMSA core curriculum to current CMSA Standards of Practice Easy-to-grasp, detailed topical outline format for quick scan of topics Complete, updated core knowledge required of case managers, with expert descriptions and direction on areas including: Case management roles, functions, tools, and processes Plans, clinical pathways, and use of technology Transitional planning Utilization management and resource management Leadership skills and concepts Quality and outcomes management; legal and ethical issues Education, training, and certification Health care insurance, benefits, and reimbursement systems Practice settings and throughput Interdisciplinary teams’ needs in: hospitals, community clinics, private practice, acute care, home care, long-term care and rehab settings, palliative care, and hospice settings Up-to-date guidance on case management specialty practices, including: nursing, life care planning, workers’ compensation, disability management, care of the elderly, behavioral health, transitions of care, subacute and long-term care, utilization review/management, primary care and medical/health home, and more Essential content for academic reference, training, certification study, case management models design, performance or program evaluation

Utilization Review

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Publisher :
ISBN 13 :
Total Pages : 25 pages
Book Rating : 4.:/5 (144 download)

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Book Synopsis Utilization Review by : National League for Nursing. Committee to Study Utilization Review Process

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:

Hospital Utilization Review

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Publisher :
ISBN 13 :
Total Pages : 22 pages
Book Rating : 4.:/5 (268 download)

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Book Synopsis Hospital Utilization Review by : Dan Ermann

Download or read book Hospital Utilization Review written by Dan Ermann and published by . This book was released on 1988 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt:

A Physician's Guide to Utilization Review

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Publisher : F. A. Davis Company
ISBN 13 :
Total Pages : 68 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis A Physician's Guide to Utilization Review by : Marshall R. Levine

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:

Guide for the Utilization Review Coordinator in a Quality Assurance Program

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Publisher :
ISBN 13 :
Total Pages : 17 pages
Book Rating : 4.:/5 (144 download)

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Book Synopsis Guide for the Utilization Review Coordinator in a Quality Assurance Program by : Hospital Research and Educational Trust. Center for Educational Innovation

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:

Utilization Review Using PAS and MAP

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Publisher :
ISBN 13 :
Total Pages : 58 pages
Book Rating : 4.:/5 (144 download)

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Book Synopsis Utilization Review Using PAS and MAP by : Commission on Professional and Hospital Activities

Download or read book Utilization Review Using PAS and MAP written by Commission on Professional and Hospital Activities and published by . This book was released on 1971 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt:

A Method of Hospital Utilization Review, by Sidney Shindell [and] Morris London. Editorial and Production Assistance by Blue Cross of Western Pennsylvania

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Publisher :
ISBN 13 :
Total Pages : 64 pages
Book Rating : 4.:/5 (977 download)

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Book Synopsis A Method of Hospital Utilization Review, by Sidney Shindell [and] Morris London. Editorial and Production Assistance by Blue Cross of Western Pennsylvania by : Sidney Shindell

Download or read book A Method of Hospital Utilization Review, by Sidney Shindell [and] Morris London. Editorial and Production Assistance by Blue Cross of Western Pennsylvania written by Sidney Shindell and published by . This book was released on 1966 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Utilization Review Criteria

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Publisher :
ISBN 13 :
Total Pages : 600 pages
Book Rating : 4.:/5 (143 download)

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Book Synopsis Utilization Review Criteria by : Bay State Health Care Foundation

Download or read book Utilization Review Criteria written by Bay State Health Care Foundation and published by . This book was released on 1975 with total page 600 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Utilization Review; Some Directions

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Publisher :
ISBN 13 :
Total Pages : 25 pages
Book Rating : 4.:/5 (741 download)

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Book Synopsis Utilization Review; Some Directions by : Council of Home Health Agencies and Community Health Services. Committee to Study Utilization Review Process

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:

The Respiratory Therapist as Disease Manager

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Publisher : Jones & Bartlett Learning
ISBN 13 : 1284168956
Total Pages : 207 pages
Book Rating : 4.2/5 (841 download)

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Book Synopsis The Respiratory Therapist as Disease Manager by : Harry R Leen

Download or read book The Respiratory Therapist as Disease Manager written by Harry R Leen and published by Jones & Bartlett Learning. This book was released on 2019-12-02 with total page 207 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written for both students and practicing clinicians, The Respiratory Therapist as Disease Manager is a foundational resource for the Respiratory Therapist who desires to augment their acute care and technical skills with a knowledge base that will enable them to competently perform the duties of a Pulmonary Disease Manager.