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Author : Stefani Daniels
Publisher :
ISBN 13 : 9781683087144
Total Pages : 141 pages
Book Rating : 4.0/5 (871 download)
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:
Author : Stefani Daniels
Publisher :
ISBN 13 : 9781645351382
Total Pages : 194 pages
Book Rating : 4.3/5 (513 download)
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
Author : Stefani Daniels
Publisher :
ISBN 13 : 9781556452147
Total Pages : 0 pages
Book Rating : 4.4/5 (521 download)
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
Author : Committee on Utilization Management by Third Parties
Publisher :
ISBN 13 :
Total Pages : 328 pages
Book Rating : 4.:/5 (5 download)
Download or read book Controlling Costs and Changing Patient Care? written by Committee on Utilization Management by Third Parties and published by . This book was released on 1989 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization management brings patient-level and system-level concerns together and represents a new nexus of relations among pagers, practitioners, hospitals, and patients. This report bears both on generic issues of knowledge and values, and on issues specific to current organizations and procedures for influencing patient care decisions. For private and public policymakers. Annotation copyrighted by Book News, Inc., Portland, OR
Author : Karen Zander
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781683085614
Total Pages : 0 pages
Book Rating : 4.0/5 (856 download)
Download or read book Case Management Models, Second Edition written by Karen Zander and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017-06-28 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Explains the differences between case management and social work and the ways in which case management functions have evolved over time. Case management is continuously evolving to meet the needs of patients and manage the quality, financial, and legal risks health care systems and accountable care organizations (ACO) face.
Author : Agency for Healthcare Research and Quality/AHRQ
Publisher : Government Printing Office
ISBN 13 : 1587634333
Total Pages : 396 pages
Book Rating : 4.5/5 (876 download)
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 396 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.
Author : Edgar H. Schein
Publisher : John Wiley & Sons
ISBN 13 : 047064057X
Total Pages : 466 pages
Book Rating : 4.4/5 (76 download)
Download or read book Organizational Culture and Leadership written by Edgar H. Schein and published by John Wiley & Sons. This book was released on 2010-07-16 with total page 466 pages. Available in PDF, EPUB and Kindle. Book excerpt: Regarded as one of the most influential management books of all time, this fourth edition of Leadership and Organizational Culture transforms the abstract concept of culture into a tool that can be used to better shape the dynamics of organization and change. This updated edition focuses on today's business realities. Edgar Schein draws on a wide range of contemporary research to redefine culture and demonstrate the crucial role leaders play in successfully applying the principles of culture to achieve their organizational goals.
Author : Stefani Daniels
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780763733544
Total Pages : 356 pages
Book Rating : 4.7/5 (335 download)
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.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309133181
Total Pages : 536 pages
Book Rating : 4.3/5 (91 download)
Download or read book The Future of the Public's Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309164257
Total Pages : 267 pages
Book Rating : 4.3/5 (91 download)
Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
Author : United States. Health Resources Administration
Publisher :
ISBN 13 :
Total Pages : 1184 pages
Book Rating : 4.:/5 (2 download)
Download or read book Health planning reports subject index written by United States. Health Resources Administration and published by . This book was released on 1979 with total page 1184 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : United States. Health Resources Administration
Publisher :
ISBN 13 :
Total Pages : 1194 pages
Book Rating : 4.M/5 ( download)
Download or read book Health Planning Reports: Subject index. 4 v written by United States. Health Resources Administration and published by . This book was released on 1978 with total page 1194 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 030913319X
Total Pages : 191 pages
Book Rating : 4.3/5 (91 download)
Download or read book Health Professions Education written by Institute of Medicine and published by National Academies Press. This book was released on 2003-07-01 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Author : Louis G. Graff
Publisher : Butterworth-Heinemann
ISBN 13 :
Total Pages : 464 pages
Book Rating : 4.3/5 (91 download)
Download or read book Observation Medicine written by Louis G. Graff and published by Butterworth-Heinemann. This book was released on 1993 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text defines the scope of observation medicine as a new and cost-effective service in the field of emergency medicine. It reviews the principles and practice of providing services in an observation unit and examines in detail the 25 most common conditions/syndromes which comprise 95 per cent of services offered in observation units.
Author : Paul Glynn
Publisher : Jones & Bartlett Learning
ISBN 13 : 0763775185
Total Pages : 281 pages
Book Rating : 4.7/5 (637 download)
Download or read book Clinical Prediction Rules written by Paul Glynn and published by Jones & Bartlett Learning. This book was released on 2011 with total page 281 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical Prediction Rules: A Physical Therapy Reference Manual, is intended to be used for multiple musculoskeletal courses. It includes musculoskeletal clinical prediction rules organized by region, thus allowing for its repeated use during the upper and lower quarter as well as in the students spine coursework. Additionally this manual includes multiple medical screening prediction rules, making it appropriate for differential diagnosis and diagnostic imaging coursework. Perfect for entry-level physical therapy programs, this text is also suitable for post-professional physical therapy programs, especially those that include an orthopaedic residency or manual therapy fellowship program, and as a reference manual for students going out on their clinical rotations.
Author : Daniel McLaughlin
Publisher : Aupha/Hap Book
ISBN 13 : 9781567938517
Total Pages : 0 pages
Book Rating : 4.9/5 (385 download)
Download or read book Healthcare Operations Management written by Daniel McLaughlin and published by Aupha/Hap Book. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This book aims to help healthcare management students and working professionals find ways to improve the delivery of healthcare, even with its complex web of patients, providers, reimbursement systems, physician relations, workforce challenges, and intensive government regulation. Taking an integrated approach, the book puts the tools and techniques of operations improvement in the context of healthcare so that readers learn how to increase the effectiveness and efficiency of tomorrow's healthcare system."--Back of the book
Author : Edward W. Marx
Publisher : CRC Press
ISBN 13 : 1000903850
Total Pages : 323 pages
Book Rating : 4.0/5 (9 download)
Download or read book Voices of Innovation written by Edward W. Marx and published by CRC Press. This book was released on 2023-07-17 with total page 323 pages. Available in PDF, EPUB and Kindle. Book excerpt: Everyone talks innovation and we can all point to random examples of innovation inside of healthcare information technology, but few repeatable processes exist that make innovation more routine than happenstance. How do you create and sustain a culture of innovation? What are the best practices you can refine and embed as part of your organization’s DNA? What are the potential outcomes for robust healthcare transformation when we get this innovation mystery solved? Through timely essays from leading experts, the first edition showcased the widely adopted healthcare innovation model from HIMSS and how providers could leverage to increase their velocity of digital transformation. Regardless of its promise, innovation has been slow in healthcare. The second edition takes the critical lessons learned from the first edition, expands and refreshes the content as a result of changes in the industry and the world. For example, the pandemic really shifted things. Now providers are more ready and interested to innovate. In the past year alone, significant disruptors (such as access to digital health) have entered the provider space threatening the existence of many hospitals and practices. This has served as a giant wake-up call that healthcare has shifted. And finally, there is more emphasis today than before on the concept of patient and clinician experience. Perhaps hastened by the pandemic, the race is on for innovations that will help address clinician burnout while better engaging patients and families. Loaded with numerous case studies and stories of successful innovation projects, this book helps the reader understand how to leverage innovation to help fulfill the promise of healthcare information technology in enabling superior business and clinical outcomes.
