More and more hospitals are choosing to become part of Accountable Care Organizations (ACO) in an effort to streamline patient care and reduce costs. If your organization is considering joining an ACO, you may have questions about how these groups work and how the change might affect your job. CMM asked several experts for the lowdown on what the transition to an ACO might mean for case managers.
Obtaining valid authorizations for disclosure is a significant area of risk for many organizations. Often, staff members handling disclosures don't understand the requirements?especially regarding when authorizations are needed and who can legally sign them. This chapter takes a comprehensive look at authorizations, including required elements, when they're needed, when they're not needed, who can sign them, and the need to screen outside authorizations.
Q: I perform monthly HIPAA audits of computer systems at the medical group where I am employed. I recently started auditing physicians and allied health professionals who are credentialed members of our medical staff.
Whether it's a precautionary CT scan that may not really be needed or a duplicate laboratory test ordered by separate physicians, many hospitalized patients are getting unnecessary tests, and experts say it's a big problem.
