News & Analysis

September 28, 2022
Case Management Monthly

Follow the cases of a patient known for refusing discharge and a patient who files a discharge appeal.

September 21, 2022
Case Management Monthly

A report released last month by the American Hospital Association (AHA), called Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs, found that not only is the cost of private health insurance raising affordability issues for American consumers, but policies, such as prior authorization requirements, may increasingly be putting patients at risk and driving up hospital administrative costs.

August 1, 2022
Briefings on APCs

The 3-day payment rule is known to coders by various names such as the 72-hour rule, the 3-day payment window, or MS-DRG window policy. Kimberly Lee M.Ed., RHIA, CCS-P, describes how to navigate the rule’s nuances for billing purposes.

July 20, 2022
Case Management Monthly

Case managers are overburdened and understaffed in hospitals across the country. With a tight job market, it’s likely that the crunch won’t lessen any time soon, so many organizations are looking to increase efficiency to ensure that they continue to meet the needs of their patients.

May 11, 2022
Case Management Monthly

Tiffany Ferguson, LMSW, ACM, and Marie Stinebuck, MBA, MSN, ACM, CEO and COO at Phoenix Medical Management Inc., discuss why the best strategy to prevent denials related to medical necessity is a proactive approach that focuses on front-end processes.

March 16, 2022
Case Management Monthly

The Important Message from Medicare (IM) Form-CMS-10065 is a document designed to inform hospitalized patients receiving inpatient services of their discharge appeal rights.