As case managers review the medical record and interview the patient, family, and medical team, they must dig deep and ask hard questions to ensure any unforeseen financial or medical needs are met.
Contract negotiations can make or break a hospital, because in addition to setting the price list for services provided to the insurer’s members, the negotiations also affect the resources that the provider expends to comply with the contract terms. Use this sample language as a template for your organization.
CMS introduced the inpatient-only list in 2001 to ensure patients who undergo complex, high-risk surgical procedures receive postoperative monitoring services in an inpatient setting.
