Experts expect the RACs to begin auditing medical necessity this summer. Case managers may be asked to play a large role in appealing medical necessity denials because of their involvement in level-of-care determinations. To help case managers, we asked Medicare appeals experts to explain the case manager’s role in the appeals process.
Considering communication is at the heart of what all case managers do, case management leaders should think about making solving the problem of language and cultural barriers a top priority.
Sarah Bush Lincoln Health Center in Mattoon, IL developed a productivity incentive plan for their coders and transcriptionists. For the hospital, the bonus plan serves as a retention and marketing tool, not to mention it has increased productivity, and the staff members appreciate it, too.
