Author : Michigan State Medical Society. Committee on Evaluation of Prepaid Medical Services
Publisher :
Page : 234 pages
File Size : 33,13 MB
Release : 1966
Category : Hospital care
ISBN :
[PDF] Hospital Utilization Review Manual eBook
Hospital Utilization Review Manual Book in PDF, ePub and Kindle version is available to download in english. Read online anytime anywhere directly from your device. Click on the download button below to get a free pdf file of Hospital Utilization Review Manual book. This book definitely worth reading, it is an incredibly well-written.
Hospital Utilization Review Manual
Author : Michigan State Medical Society. Committee on Evaluation of Prepaid Medical Services
Publisher :
Page : 234 pages
File Size : 34,89 MB
Release : 1966
Category : Hospital care
ISBN :
The Hospital Guide to Contemporary Utilization Review
Author : Stefani Daniels
Publisher :
Page : 0 pages
File Size : 14,53 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
Hospital Utilization Review and Medicare
Author : Rona Beth Schumer
Publisher :
Page : 130 pages
File Size : 14,99 MB
Release : 1971
Category : Health insurance
ISBN :
Controlling Costs and Changing Patient Care?
Author : Institute of Medicine
Publisher : National Academies Press
Page : 321 pages
File Size : 46,37 MB
Release : 1989-01-01
Category : Medical
ISBN : 0309040485
Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
The Use of the Hospital Utilization Review Manual Criteria and Record Abstracts for Medical Record Review in a Hospital Committee Setting
Author :
Publisher :
Page : 240 pages
File Size : 24,3 MB
Release : 1970
Category : Hospital records
ISBN :
The Hospital Guide to Contemporary Utilization Review
Author : Stefani Daniels
Publisher :
Page : 141 pages
File Size : 32,52 MB
Release : 2018
Category : Medical care
ISBN : 9781683087144
The Hospital Guide to Contemporary Utilization Review, Third Edition
Author : Stefani Daniels
Publisher :
Page : 194 pages
File Size : 37,21 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
Reimbursement Manual for Hospital-conducted Utilization Review Activities
Author : Peat, Marwick, Mitchell & Co
Publisher :
Page : 18 pages
File Size : 26,38 MB
Release : 1977
Category :
ISBN :
The CMS Hospital Conditions of Participation and Interpretive Guidelines
Author :
Publisher :
Page : 546 pages
File Size : 50,28 MB
Release : 2017-11-27
Category :
ISBN : 9781683086857
In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.