| Description |
1 online resource |
| Contents |
Machine derived contents note: How to Use theTools on the CD-ROM vii -- Chapter 1:What is Observation Status, Really? 1 -- A Brief H istory 1 -- What Does Count As Observation Status 6 -- What Does Not Count as Observation Status 9 -- Other Observation Status Requirements 10 -- Chapter 2: Determining the Right Level of Care Status 17 -- Inpatient Services Defined 17 -- Changing a Patient's Status 22 -- O ther Level of Care O ptions 22 -- Outpatient (APC) Procedures as Inpatient 28 -- Physician O rders 29 -- Chapter 3: Consequences of Incorrect Level of Care Determinations 33 -- CMS Strategies for Measuring Accuracy 33 -- Corrective Action Plan 35 -- Provider R esponse 37 -- O IG Investigation 43 -- Chapter 4: Using Data to Determine Improvement Opportunities 45 -- External D ata 45 -- Evaluating External Data 49 -- Internal Data Collection 50 -- Chapter 5: Quick and Not-So-Quick Fixes for Incorrect Level of Care 55 -- Correcting Level of Care Determ inations 55 -- Composition of Utilization Review Committee 60 -- C orrecting Level of C are O rders 62 -- Chapter 6: The Role of the Physician Advisor -- By Joan C. Ragsdale, JD, and Ann M. Purdy, CPA 81 -- Bringing Patient Care and Level of Care Designations Together 81 -- Physician A dvisor R ole 82 -- Benefits of Having a Physician Advisor 83 -- Choosing an Effective Physician Advisor 84 -- O n-staff physicians 84 -- C ase Stu d ies 8 6 -- Physician Advisors Aid in Compliance 88 -- Chapter 7: Strategies for Achieving Accurate Reimbursement 89 -- O btain Optim al Reim bursem ent 89 -- Observation Payment History 90 -- R evenue C odes 96 -- Other Observation Reimbursement Opportunities 96 -- Im provem ent Strategies 98 -- C om pliance G uidance 98 -- O IG W ork Plan 2006 100 -- Chapter 8: The Medicare Appeals Process 101 -- Strategies for H andling Denials 101 -- The A ppeals Process 103 -- D enial M anagem ent 107 -- Nursing Education Instructional Guide 109 -- C ontinuing Education 111 -- Continuing Education Exam 113 -- Continuing Education Evaluation 118 |
| Notes |
System requirements: Windows 95/98 or greater with Windows operating sytem |
| Subject |
Diagnosis-Related Groups.
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Case Management -- standards.
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Medicaid -- standards.
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Medicare -- standards.
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Hospitals -- Administration.
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| Form |
Electronic book
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| LC no. |
2009419019 |
| ISBN |
9781601462084 |
|
1601462085 |
|
