News & Analysis

July 1, 2019
Medicare Web

Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?

July 1, 2019
Case Management Monthly

If you’re feeling drained and uninspired at work lately, you’re not alone. A survey published in the June 4 issue of Annals of Internal Medicine found that burnout among doctors costs the U.S. healthcare system some $4.6 billion each year due to turnover and reduced clinical hours.

July 1, 2019
Case Management Monthly

Case managers typically provide support to adult patients in the hospital, focusing on their medical and social needs and easing their transition to the next level of care. But often, these patients aren’t the only ones who need support—they sometimes also have children or grandchildren who are struggling.

July 1, 2019
Briefings on APCs

In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.

July 1, 2019
Briefings on APCs

Before starting an ambulatory or outpatient CDI program, those tasked with the project must first create some universal definitions so everyone is on the same page and speaking the same language.

June 28, 2019
Case Management Monthly

A medical center case manager must deal with a patient who presents a Medicaid insurance card that is not hers on admission.

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