At this juncture in the evolution of case management services, we have reached the tipping point of hospitals acknowledging that they should have some evaluation of each patient’s level-of-care needs at the front door.
Instead of paying for hospital and physician services separately, the ACE demonstration program bundles payments for specific cardiac and orthopedic procedures into one lump sum to encourage collaboration.
You receive a letter in the mail requesting copies of medical records for an audit. It looks much like the one you received the day before, but the return address is different. And they both look quite similar to the other request for documentation you received last week.