Case Management

Gerald is a 47-year-old male with a history of drug abuse and suicide attempts. He also presents to the ED at least twice per week. 

Medicare guidelines state that patients must be given a choice when it comes to their discharge options, but hospitals have a number of other options when it comes to discussing discharge plans with their patients.

In a recent HCPro audio conference titled “ Observation Services v. Inpatient Admission: Assign Proper Level of Care and Prevent Denials,” experts answered listeners’ questions about proper use of observation services. 

Finding a tool that organizes the discharge process into a framework may provide for a more timely and accurate plan. 

One of the more talked-about initiatives in the Patient Protection and Affordable Care Act is the creation of accountable care organizations (ACO) and the global payment pilot projects. 

Several facilities share their strategies for caring for IV drug users that require IV antibiotic treatment. 

Care providers accept the general principle that patients have the right to direct their own care, but what if the patient refuses every discharge option you provide and wants to stay in inpatient care indefinitely? 

The rules for making proper level-of-care decisions are lengthy and confusing, which makes the role of the physician advisor within the utilization review (UR) committee extremely critical.

Condition code 44 has been problematic for hospitals since its inception in 2004 due to CMS’ unclear language, multiple changes to the observation billing rules, and inconsistent guidance.

A hospital case management team digs into a patient's past to uncover information to help create a safe and sucessful dicharge plan.