Whether it's a precautionary CT scan that may not really be needed or a duplicate laboratory test ordered by separate physicians, many hospitalized patients are getting unnecessary tests, and experts say it's a big problem.
Many hospitals have added case managers to their EDs, but these case managers face unique situations. CMM experts answer questions about how to handle these issues.
More and more hospitals are choosing to become part of Accountable Care Organizations (ACO) in an effort to streamline patient care and reduce costs. If your organization is considering joining an ACO, you may have questions about how these groups work and how the change might affect your job. CMM asked several experts for the lowdown on what the transition to an ACO might mean for case managers.
Condition codes can cause considerable confusion for case managers. Coders use them to support payment for out-of-the-ordinary situations?for example, an inpatient being changed to outpatient status.
EDs have a lot to handle. One in every three Americans will visit an ED each year, and among those are a number of populations that bring special challenges.
In November 2014, CMS put its certification requirement under the 2-midnight rule to bed, finally conceding that the rule was creating more problems than it solved. While many frustrated case managers celebrated this development, they still aren't completely off the hook. CMS replaced the global certification requirement with two more-specific certification requirements that went into place on January 1, and case managers need to be aware of them.
