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.
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.
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.
Many of the facilities that once specialized in mental health services across the country have shut their doors in recent years, making it more likely than ever that hospitals will encounter patients with mental health needs in the emergency department (ED).
If your department is looking for a new case manager, the stakes can be high. Hiring the wrong person can result in lost time, money, and productivity. Find the right fit the first time by following some simple strategies that help you move past the candidate's paper persona and get a better picture of how he or she will perform in a real-life setting.
This January, CMS expanded its readmissions prevention program, adding two more procedures to its list of conditions for which hospitals can be penalized if patients with the conditions are readmitted to the hospital within 30 days of discharge. To prevent these readmissions, hospitals and case managers need to understand the factors that drive them.
