Helping patients with diabetes manage their care and avoid preventable readmissions is challenging under normal circumstances, but even more so during the COVID-19 pandemic.
As the COVID-19 pandemic has surged, hospitals and healthcare providers have increasingly taken advantage of technology to provide routine care to patients and monitor them after discharge.
Case management directors and utilization review (UR) case managers beware! In a Frequently Asked Questions (FAQ) document released in July, CMS said it expects to discontinue enforcement discretion for Medicare fee-for-service medical reviews beginning August 3, regardless of the status of the public health emergency (PHE).
Matty, an expert utilization review (UR) case manager, is shocked when she receives a letter denying payment for the entire hospital stay of Michael, who has recovered after falling severely ill with the novel coronavirus (COVID-19).
Case managers use a lot of lists. They use lists of nursing homes, lists of community organizations, and lists of other resources that are designed to help their patients.
But there are times when a list is not the best option, saysDiane Iverson, RN, BSN, BS, ACM, CCM, a Baltimore-area case manager. For example, when case managers are working with individuals seeking assistance for substance use disorders, lists of resources may not be effective.
