News & Analysis

January 1, 2011
Case Management Monthly

Finding a tool that organizes the discharge process into a framework may provide for a more timely and accurate plan. 

December 1, 2010
Case Management Monthly

Condition code 44 has been problematic for hospitals since its inception in 2004 due to CMS’ unclear language, multiple changes to the observation billing rules, and inconsistent guidance.

November 1, 2010
Case Management Monthly

CMS has seen an increase in the number of extended observation stays and wants to know why. That was the reason it gave for holding an August 24 listening session regarding the matter. The reason providers misuse observation services may not have been as interesting as the solution proposed by some callers—namely, that CMS should abolish observation services. 

October 1, 2010
Case Management Monthly

To begin to think about separating the UR function from the case management role, you must question the validity of the functional model