Matty, an expert utilization review (UR) case manager, is shocked when she receives a letter denying payment for the entire hospital stay of Michael, who has recovered after falling severely ill with the novel coronavirus (COVID-19).
Q: As utilization review case managers, we are often tasked with assessing our hospital's risk for novel coronavirus (COVID-19) denials. What are the most important measures we should be examining?
Case management directors and utilization review (UR) case managers beware! In a Frequently Asked Questions (FAQ) document released in July, CMS said it expects to discontinue enforcement discretion for Medicare fee-for-service medical reviews beginning August 3, regardless of the status of the public health emergency (PHE).
Q: As a case manager, part of my job is making sure my patients are capable of utilizing technology to access telemedicine. What are your recommendations for helping patients get up to speed with technology?
As the COVID-19 pandemic has surged, hospitals and healthcare providers have increasingly taken advantage of technology to provide routine care to patients and monitor them after discharge.
Q: How can case managers help patients, especially those dealing with chronic diseases such as diabetes, access care during the novel coronavirus (COVID-19) pandemic?
