News & Analysis

January 25, 2023
Case Management Monthly

Julie, a case manager, understands that meeting the demands of the patient and family is important. However, she also knows that hospitals are responsible for safe discharges.

October 26, 2022
Case Management Monthly

Jessie, a nurse case manager, feels healthcare has changed since the beginning of the pandemic. She believes that the greatest change comes from the recent initiation of new healthcare coverage plans, primarily Medicaid managed care and Medicare Advantage.

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.