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.
Last month, we laid the foundation to promote successful engagement of the coding and clinical documentation improvement teams in PSI 90 performance improvement efforts.
It's been two years since the American Health Information Management Association joined ACDIS to offer the industry physician query instructions in Guidelines for Achieving a Compliant Query Practice, published in February 2013.
Incentives posed by the Institute for Healthcare Improvement's Triple Aim Initiative and value-based purchasing emphasize treating the whole person to include preventive, medical, dental, postacute, community, mental health, and addiction services.
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.
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.
