The Rac Toolkit for Hospitals and Health Systems

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ISBN 13 : 9781601468284
Total Pages : 0 pages
Book Rating : 4.4/5 (682 download)

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Book Synopsis The Rac Toolkit for Hospitals and Health Systems by : Elizabeth E. Lamkin

Download or read book The Rac Toolkit for Hospitals and Health Systems written by Elizabeth E. Lamkin and published by . This book was released on 2011-05-20 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program Amanda W. Berglund, MS, MBA; Elizabeth E. Lamkin, MHA Learn how to respond to RAC audits. And more importantly, how to prevent them. The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program is your answer to turning plans into proactive action for RAC success. Authors Elizabeth E. Lamkin, MHA, and Amanda W. Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program. Whether you are responding to a Recovery Auditor or another government auditor, your program must operate as effectively as possible. You will use their tested, proven, and practical tools that will help you build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical staff together for operational improvements that directly affect your bottom line. The RAC Toolkit for Hospitals and Health Systems will help you get the job done right. The RAC Toolkit for Hospitals and Health Systems will help you achieve the following goals: Take a systemic approach to RAC compliance Incorporate effective structure and processes to existing systems for measurable results Organize committees and facilitate information flow Appeal effectively and within deadlines Use proven tools and methods for an effective RAC program Table of Contents: Chapter 1: RAC Program Overview Chapter 2: Preparing for RAC Chapter 3: The Right Structure: Organizing the Committees Chapter 4: The Right People: Three Critical Roles for RAC Prevention Chapter 5: Additional RAC Stakeholders Chapter 6: Automated Reviews Chapter 7: Complex Review and Extrapolation Chapter 8 The Appeal Appendix (Acronyms and additional resources) Take advantage of these valuable tools included in your book: RAC appeal timeline RAC preparedness checklist RAC committee structure flowchart Organizational chart for RAC-related personnel Sample RAC committee meeting agenda Sample UR committee meeting agenda Complex case review worksheet Admission review continued stay and discharge review flowchart Patient status change letter template Automated review timeline Complex review timeline Appeal letter template for appeal level 1 redetermination CMS form 20027 CMS form 20034 CMS form DAB101

Tools for Hospitals and Health Care Systems

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (19 download)

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Book Synopsis Tools for Hospitals and Health Care Systems by :

Download or read book Tools for Hospitals and Health Care Systems written by and published by . This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Core Skills for Hospital Case Managers

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Publisher : HC Pro, Inc.
ISBN 13 : 1601463537
Total Pages : 319 pages
Book Rating : 4.6/5 (14 download)

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Book Synopsis Core Skills for Hospital Case Managers by : Tony Cesta

Download or read book Core Skills for Hospital Case Managers written by Tony Cesta and published by HC Pro, Inc.. This book was released on 2009-06 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes Toni Cesta, PhD, RN, FAAN; Beverly Cunningham, MS, RN As of June 20, 2014, contact hours for nurses are no longer available with this product. Finally--an affordable, effective, and consistent training program for your hospital case managers. This one-of-a-kind guide to fundamental case management responsibilities is a necessary reference tool for every hospital case management department. This resource is designed to give case management directors and hospital leaders the tools they need to build and strengthen the basic and advanced skills their case management staff needs to succeed. Core Skills for Hospital Case Managers is an orientation and training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to develop and maintain a wide variety of care management skills. Table of contents Chapter 1: Hospital Case Management 101 Chapter 2: Case Manager Role Chapter 3: Roles, Functions, and Caseloads Chapter 4: The Case Management Process Chapter 5: The Case Manager's Role in Transitional and Discharge Planning Chapter 6: Utilization Management Chapter 7: Managing Long Length of Stay Patients Chapter 8: Denials: Prevention and Appeals Strategies Chapter 9: Reimbursement Chapter 10: The Role of the Case Manager in Patient Flow Chapter 11: Measuring Success: Strategic Outcome Measures Chapter 12: Dealing with the Uninsured and Underinsured Chapter 13: Working with Multidisciplinary Teams Chapter 14: Crucial Communication and Conflict Resolution Learning objectives: Discuss the evolution of hospital case management Explain the different models of hospital case management Determine the various goals of hospital case management Examine the various roles of case management Discuss the variety of functions performed by case managers Discuss the scope of the case manager position Examine staffing ratios in various models List the steps in the case management process Determine the role of case managers in documentation Examine case managers' role in discharge planning List the factors that influence the discharge planning process Determine strategies for improving discharge planning Discuss how hospital reimbursement affects utilization management (UM) List the stages of UM coordination Determine the affect of outside influences on UM Evaluate different payers' regulations regarding UM Examine case management's role in length of stay (LOS) Evaluate strategies for managing patients with long LOS Identify data used to track and trend LOS Evaluate the reasons behind denials Discuss case management's role in preventing denials Examine case management's roles in reversing denials Examine case management's role in reimbursement Determine strategies for effective case management related to reimbursement Evaluate case management's role in patient flow Discuss demand and capacity management Identify strategies for managing patient flow Identify measurable case management outcomes Explain how case managers can track quality outcome metrics Discuss other metrics case management departments can track and trend Examine ways to create a case management report card Discuss the unfunded or underfunded patient populations Describe the role of the ED case manager with unfunded or underfunded patient populations Evaluate strategies for dealing with unfunded or underfunded patient populations Examine strategies for successfully working with multidisciplinary teams Describe sources of conflict with which case managers frequently come in contact Discuss strategies for reducing conflict Intended audience Staff nurses, charge nurses, staff educators, staff development specialists, directors of education, nurse managers, and nurse leaders

Health Care Finance and the Mechanics of Insurance and Reimbursement

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Publisher : Jones & Bartlett Learning
ISBN 13 : 1284203298
Total Pages : 344 pages
Book Rating : 4.2/5 (842 download)

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Book Synopsis Health Care Finance and the Mechanics of Insurance and Reimbursement by : Michael K. Harrington

Download or read book Health Care Finance and the Mechanics of Insurance and Reimbursement written by Michael K. Harrington and published by Jones & Bartlett Learning. This book was released on 2019-10-01 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care Finance and the Mechanics of Insurance and Reimbursement stands apart from other texts on health care finance or health insurance, in that it combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Thoroughly updated for its second edition, this text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.

Fundamentals of Clinical Data Science

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Publisher : Springer
ISBN 13 : 3319997130
Total Pages : 219 pages
Book Rating : 4.3/5 (199 download)

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Book Synopsis Fundamentals of Clinical Data Science by : Pieter Kubben

Download or read book Fundamentals of Clinical Data Science written by Pieter Kubben and published by Springer. This book was released on 2018-12-21 with total page 219 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book comprehensively covers the fundamentals of clinical data science, focusing on data collection, modelling and clinical applications. Topics covered in the first section on data collection include: data sources, data at scale (big data), data stewardship (FAIR data) and related privacy concerns. Aspects of predictive modelling using techniques such as classification, regression or clustering, and prediction model validation will be covered in the second section. The third section covers aspects of (mobile) clinical decision support systems, operational excellence and value-based healthcare. Fundamentals of Clinical Data Science is an essential resource for healthcare professionals and IT consultants intending to develop and refine their skills in personalized medicine, using solutions based on large datasets from electronic health records or telemonitoring programmes. The book’s promise is “no math, no code”and will explain the topics in a style that is optimized for a healthcare audience.

Hospitals & Health Care Organizations

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Publisher : CRC Press
ISBN 13 : 1466575816
Total Pages : 417 pages
Book Rating : 4.4/5 (665 download)

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Book Synopsis Hospitals & Health Care Organizations by : David Edward Marcinko

Download or read book Hospitals & Health Care Organizations written by David Edward Marcinko and published by CRC Press. This book was released on 2012-07-06 with total page 417 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drawing on the expertise of decision-making professionals, leaders, and managers in health care organizations, Hospitals & Health Care Organizations: Management Strategies, Operational Techniques, Tools, Templates, and Case Studies addresses decreasing revenues, increasing costs, and growing consumer expectations in today‘s increasingly competi

Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications

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Publisher : IGI Global
ISBN 13 : 1522539271
Total Pages : 1630 pages
Book Rating : 4.5/5 (225 download)

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Book Synopsis Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications by : Management Association, Information Resources

Download or read book Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications written by Management Association, Information Resources and published by IGI Global. This book was released on 2017-12-01 with total page 1630 pages. Available in PDF, EPUB and Kindle. Book excerpt: The development of better processes to provide proper healthcare has enhanced contemporary society. By implementing effective collaborative strategies, this ensures proper quality and instruction for both the patient and medical practitioners. Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications is a comprehensive reference source for the latest scholarly material on emerging strategies and methods for delivering optimal healthcare and examines the latest techniques and methods of clinical science. Highlighting a range of pertinent topics such as medication management, health literacy, and patient engagement, this multi-volume book is ideally designed for professionals, practitioners, researchers, academics, and graduate students interested in healthcare delivery and clinical science.

Foundations of Health Services Research

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Publisher : Springer
ISBN 13 : 9783031299971
Total Pages : 0 pages
Book Rating : 4.2/5 (999 download)

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Book Synopsis Foundations of Health Services Research by : Michel Wensing

Download or read book Foundations of Health Services Research written by Michel Wensing and published by Springer. This book was released on 2023-06-30 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This textbook provides a comprehensive introduction to health services research. Health services research uses empirical studies to address challenges in the delivery and organization of health care. The book focuses on healthcare delivery (micro-level), which is embedded in institutions such as hospitals (meso-level) and healthcare systems (macro-level). The quality of the research approach determines the value of health services research to a large extent. The book, therefore, puts emphasis on research principles and research methods. The book provides an evidence-informed perspective on principles, methods and topics of health services research and uses examples of studies throughout the text. The 24 chapters are organised in four sections: Introduction to Health Services Research Principles of Health Services Research Research Methods in Health Services Research Emerging Topics in Health Services Research Foundations of Health Services Research: Principles, Methods, and Topics gives an overview of tools and strategies for learning and teaching at master and doctoral levels. It also is a useful resource for health researchers in clinical science and public health. Policy-makers and healthcare managers might also find the book helpful for their work.

Health Information Systems: Concepts, Methodologies, Tools, and Applications

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Publisher : IGI Global
ISBN 13 : 160566989X
Total Pages : 2311 pages
Book Rating : 4.6/5 (56 download)

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Book Synopsis Health Information Systems: Concepts, Methodologies, Tools, and Applications by : Rodrigues, Joel J.P.C.

Download or read book Health Information Systems: Concepts, Methodologies, Tools, and Applications written by Rodrigues, Joel J.P.C. and published by IGI Global. This book was released on 2009-12-31 with total page 2311 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This reference set provides a complete understanding of the development of applications and concepts in clinical, patient, and hospital information systems"--Provided by publisher.

Emergency and Disaster Management: Concepts, Methodologies, Tools, and Applications

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Publisher : IGI Global
ISBN 13 : 152256196X
Total Pages : 1758 pages
Book Rating : 4.5/5 (225 download)

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Book Synopsis Emergency and Disaster Management: Concepts, Methodologies, Tools, and Applications by : Management Association, Information Resources

Download or read book Emergency and Disaster Management: Concepts, Methodologies, Tools, and Applications written by Management Association, Information Resources and published by IGI Global. This book was released on 2018-07-06 with total page 1758 pages. Available in PDF, EPUB and Kindle. Book excerpt: In a world of earthquakes, tsunamis, and terrorist attacks, emergency response plans are crucial to solving problems, overcoming challenges, and restoring and improving communities that have been affected by these catastrophic events. Although the necessity for quick and efficient aid is understood, researchers and professionals continue to strive for the best practices and methodologies to properly handle such significant events. Emergency and Disaster Management: Concepts, Methodologies, Tools, and Applications is an innovative reference source for the latest research on the theoretical and practical components of initiating crisis management and emergency response. Highlighting a range of topics such as preparedness and assessment, aid and relief, and the integration of smart technologies, this multi-volume book is designed for emergency professionals, policy makers, practitioners, academicians, and researchers interested in all aspects of disaster, crisis, and emergency studies.

Health Care Finance and the Mechanics of Insurance and Reimbursement

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Publisher : Jones & Bartlett Publishers
ISBN 13 : 1284026159
Total Pages : 370 pages
Book Rating : 4.2/5 (84 download)

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Book Synopsis Health Care Finance and the Mechanics of Insurance and Reimbursement by : Michael K. Harrington

Download or read book Health Care Finance and the Mechanics of Insurance and Reimbursement written by Michael K. Harrington and published by Jones & Bartlett Publishers. This book was released on 2015-02-27 with total page 370 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book addresses the methods and process for reimbursement, including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing. With up-to-date coverage of the Affordable Care Act, this text will prepare health administration and health information management students with the necessary tools to successfully transition from the classroom to the health care facility. Some of the topics covered include: claims processing; the Affordable Care Act; Medicare Prospective Payment System (Inpatient); Medicare Outpatient Prospective Payment Systems (Non-Inpatient); coding for the non-HIM professional; revenue cycle management; healthcare fraud and abuse; electronic health records and meaningful use; government incentive programs; recovery audit contractors student & instructor resources. --

תופעות של שינויים ספרותיים- היסטוריוגרפיים בטקסטים המקבילים בין ספר דברי הימים לספרי שמואל ומלכים...

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (762 download)

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Book Synopsis תופעות של שינויים ספרותיים- היסטוריוגרפיים בטקסטים המקבילים בין ספר דברי הימים לספרי שמואל ומלכים... by :

Download or read book תופעות של שינויים ספרותיים- היסטוריוגרפיים בטקסטים המקבילים בין ספר דברי הימים לספרי שמואל ומלכים... written by and published by . This book was released on 1989 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

New Tools for Curbing Waste and Fraud in Medicare and Medicaid

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Publisher :
ISBN 13 :
Total Pages : 152 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis New Tools for Curbing Waste and Fraud in Medicare and Medicaid by : United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security

Download or read book New Tools for Curbing Waste and Fraud in Medicare and Medicaid written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security and published by . This book was released on 2011 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Financial Management of Health Care Organizations

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Publisher : John Wiley & Sons
ISBN 13 : 1118466586
Total Pages : 776 pages
Book Rating : 4.1/5 (184 download)

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Book Synopsis Financial Management of Health Care Organizations by : William N. Zelman

Download or read book Financial Management of Health Care Organizations written by William N. Zelman and published by John Wiley & Sons. This book was released on 2013-12-17 with total page 776 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new Fourth Edition of Financial Management of Health Care Organizations, offers an introduction to the most-used tools and techniques of health care financial management, including health care accounting and financial statements; managing cash, billings and collections; making major capital investments; determining cost and using cost information in decision-making; budgeting and performance measurement; and pricing. New to this edition: The Perspectives sections and the glossary have been updated. The book features a cutting-edge view of the health care landscape in 2013 and beyond after passage and pending implementation of the Affordable Care Act. Areas of expanded content include revised examples of financial statements for both private non-profit hospitals and investor-owned hospital management companies, changes in bad debt and charity care, the role of financial statements, the discount rate or cost of capital, lease financing section, use of cost information, budgeting, cost centers, and current forms of reimbursement Content new to this edition includes valuation of accounts receivable and the "waterfall" effect of cash collections, differences between Posting-Date and Service-Date reporting methodologies, calculation of effective annual interest rate, application of time value of money in perspectives, and Activity-Based Costing from the perspective of labor, supplies, and equipment.

Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From University of Iowa Hospitals & Clinics, Second Edition

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Publisher : Sigma Theta Tau
ISBN 13 : 1948057956
Total Pages : 670 pages
Book Rating : 4.9/5 (48 download)

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Book Synopsis Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From University of Iowa Hospitals & Clinics, Second Edition by : Laura Cullen

Download or read book Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From University of Iowa Hospitals & Clinics, Second Edition written by Laura Cullen and published by Sigma Theta Tau. This book was released on 2022-07-27 with total page 670 pages. Available in PDF, EPUB and Kindle. Book excerpt: “Building on extensive real-life experience with EBP, this expert team from University of Iowa Hospitals & Clinics provides vital guidance to clinicians at the cutting edge of care improvement.” –Kathleen R. Stevens, EdD, MS, RN, ANEF, FAAN Castella Endowed Distinguished Professor School of Nursing and Institute for Integration of Medicine & Science (CTSA) University of Texas Health Science Center San Antonio “This new edition is essential for all who want to deliver evidence-based care. Beautifully organized, it is readable, practical, and user-friendly.” –Kathleen C. Buckwalter, PhD, RN, FAAN Professor Emerita, University of Iowa College of Nursing Distinguished Nurse Scientist in Aging, Reynolds Center Oklahoma University Health Sciences Center, College of Nursing “Evidence-Based Practice in Action, Second Edition, will continue to ensure high-quality, evidence-based care is implemented in healthcare systems across the country — and the world. It should also be a well-worn tool in every implementation scientist’s toolkit. –Heather Schacht Reisinger, PhD Professor, Department of Internal Medicine Associate Director for Engagement, Integration and Implementation Institute for Clinical and Translational Science, University of Iowa Translate knowledge, research, and clinical expertise into action. The biggest barrier to effective evidence-based practice (EBP) is the failure to effectively translate available knowledge, research, and clinical expertise into action. This failure is rarely due to lack of information, understanding, or experience. In fact, it usually comes down to a simple lack of tools and absence of a clear plan to integrate EBP into care. Problem solved: Evidence-Based Practice in Action, Second Edition, is a time-tested, application-oriented EBP resource for any EBP process model and is organized based on The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care. This book offers a proven, detailed plan to help nurses and healthcare professionals promote and achieve EBP implementation, adoption, sustained use. TABLE OF CONTENTS Chapter 1: Identify Triggering Issues/Opportunities Chapter 2: State the Question or Purpose Chapter 3: Is This Topic a Priority? Chapter 4: Form a Team Chapter 5: Assemble, Appraise, and Synthesize Body of Evidence Chapter 6: Is There Sufficient Evidence? Chapter 7: Design and Pilot the Practice Change Chapter 8: Evaluation Chapter 9: Implementation Chapter 10: Is Change Appropriate for Adoption in Practice? Chapter 11: Integrate and Sustain the Practice Change Chapter 12: Disseminate Results Appendix A: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care Appendix B: Iowa Implementation for Sustainability Framework Appendix C: Select Evidence-Based Practice Models Appendix D: Glossary

Geriatric Emergency Medicine

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Publisher : Cambridge University Press
ISBN 13 : 1107677645
Total Pages : 383 pages
Book Rating : 4.1/5 (76 download)

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Book Synopsis Geriatric Emergency Medicine by : Joseph H. Kahn

Download or read book Geriatric Emergency Medicine written by Joseph H. Kahn and published by Cambridge University Press. This book was released on 2014-01-16 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.

Preventing Health Care Fraud

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Publisher :
ISBN 13 :
Total Pages : 128 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis Preventing Health Care Fraud by : United States. Congress. Senate. Committee on Finance

Download or read book Preventing Health Care Fraud written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2011 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: