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Author : Stefani Daniels
Publisher :
Page : 141 pages
File Size : 39,66 MB
Release : 2018
Category : Medical care
ISBN : 9781683087144
Author : Stefani Daniels
Publisher :
Page : 0 pages
File Size : 38,62 MB
Release : 2015-04-16
Category : Hospital utilization
ISBN : 9781556452147
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Author : Stefani Daniels
Publisher :
Page : 194 pages
File Size : 17,96 MB
Release : 2021-10
Category :
ISBN : 9781645351382
The Hospital Guide to Contemporary Utilization Review, Third Edition, is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations in a value-based world. The book covers a range of topics, including compliance with the UR Conditions of Participation (CoP), legal obligations of a hospital, contract language, and compliant UR plan language, to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best-practice hospital UR program Describe the legal obligations of the hospital to comply with Chapter 42 CFR 482.30 of the CoP Use the publication as a tool to assess your own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Differentiate between traditional Medicare and Medicare Advantage Facilitate the development of a contemporary UR committee Discuss the pros and cons of the possible reporting structures for UR activities Examine the role of the physician advisor as a member of the UR team Recognize the crucial role of revenue cycle in the work of the UR specialist Recommend compliant language for your organization's UR plan Describe the components of the revenue cycle pertinent to UR Differentiate inpatient and outpatient payment rules Explain the basics of claim preparation Review physician billing and payment rules Differentiate between national coverage determinations, local coverage determinations, and commercial payer criteria Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good UR plan and a hospital's revenue cycle initiatives
Author : Marshall R. Levine
Publisher : F. A. Davis Company
Page : 68 pages
File Size : 16,31 MB
Release : 1987
Category : Medical
ISBN :
Author : Jeff Steiner
Publisher :
Page : 99 pages
File Size : 37,18 MB
Release : 2013-08-10
Category : Physicians
ISBN : 9780989840101
An outline review of personal finance for physicians.
Author : Jeffrey T. Gorke
Publisher : Greenbranch Pub Llc
Page : 155 pages
File Size : 17,13 MB
Release : 2010-01-01
Category : Business & Economics
ISBN : 9780981473802
Nationally known healthcare consultant Jeffrey Gorke translates his 20 years of experience into a winning playbook for joining, starting or running a "dream" practice. Packed with tips, insights and action-oriented tools, this fast-paced guide helps readers rapidly master the language, players, management structures and culture issues and use what they've learned to ask all the right questions in identifying, seeking and landing the absolute best job. Learn how to size up location, compensation, work-life balance, and the freedom to practice medicine! NOTEWORTHY FEATURES - A comprehensive, step-by-step check list makes sure you cover every question in the practice-selection process and lets you do revealing side-by-side comparisons of all the practices under consideration. - Practical tips and reality checkpoints on what to expect in the private practice setting. - Instant financial mastery: Spreadsheets and graphical presentations make it easy for readers to evaluate business and financial data to learn what's really happening in a practice — and what questions you'll need to keep asking if you decide to join. - Clear action steps: How to evaluate factors such as a practice's location or culture and what plusses and minuses to look for in terms of managers, consultants, and business structure. - And a Bonus! Illustrative real-life anecdotes from the medical practice trenches.
Author : David B. Nash
Publisher : Jones & Bartlett Learning
Page : 280 pages
File Size : 19,13 MB
Release : 1994
Category : Medical
ISBN : 9780834203938
You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
Author : Robert B. Tobias
Publisher :
Page : pages
File Size : 13,41 MB
Release : 1986
Category :
ISBN :
Author : James A. Howenstine
Publisher :
Page : 0 pages
File Size : 49,78 MB
Release : 2002
Category : Health & Fitness
ISBN : 9780970568489
An important book from a noted medical doctor, this book describes exactly what natural health products work for specific diseases. A scientifically trained medical doctor, Dr. Howerstein, spans the gap between medical science and natural health products.
Author : Sara C. Charles M.D.
Publisher : Oxford University Press
Page : 288 pages
File Size : 33,29 MB
Release : 2005-04-14
Category : Medical
ISBN : 019029132X
What is it like to be sued for medical malpractice? Bad medical outcomes traumatize patients but they also traumatize physicians. The litigation that often follows is a profoundly human, rather than just a legal experience. Although every physician's case is different, this book shows how each case goes through the same judicial stages of complaint, discovery, depositions, motions, and delays that lead to trial, settlement, or being dropped. It also gives doctors an understanding of how lawyers think and work to help defendants. Written by a physician and a lawyer, the book provides unique insights - through real-life stories - into the personal experience of litigation as well as recommendations for dealing with each of the legal process. It also includes up-to-date reviews of HIPAA legislation, the controversial subject of disclosure, and recent developments in the law affecting medical practitioners. Only about thirty percent of plaintiffs win their cases against doctors, but the journey from bedside to witness stand tests both the personal character and the professional skills of those accused. This well-documented book will help doctors understand and navigate the legal system while honoring their own ideals and emerging changed but stronger from the experience.