Hospital Utilization Review Manual PDF Download
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Author | : Michigan State Medical Society. Committee on Evaluation of Prepaid Medical Services |
Publisher | : |
Total Pages | : 234 |
Release | : 1966 |
Genre | : Hospital care |
ISBN | : |
Download Hospital Utilization Review Manual Book in PDF, ePub and Kindle
Author | : Michigan State Medical Society. Committee on Evaluation of Prepaid Medical Services |
Publisher | : |
Total Pages | : 234 |
Release | : 1966 |
Genre | : Hospital care |
ISBN | : |
Download Hospital Utilization Review Manual Book in PDF, ePub and Kindle
Author | : Stefani Daniels |
Publisher | : |
Total Pages | : 0 |
Release | : 2015-04-16 |
Genre | : Hospital utilization |
ISBN | : 9781556452147 |
Download The Hospital Guide to Contemporary Utilization Review Book in PDF, ePub and Kindle
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 | : Rona Beth Schumer |
Publisher | : |
Total Pages | : 130 |
Release | : 1971 |
Genre | : Health insurance |
ISBN | : |
Download Hospital Utilization Review and Medicare Book in PDF, ePub and Kindle
Author | : Institute of Medicine |
Publisher | : National Academies Press |
Total Pages | : 321 |
Release | : 1989-01-01 |
Genre | : Medical |
ISBN | : 0309040485 |
Download Controlling Costs and Changing Patient Care? Book in PDF, ePub and Kindle
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.
Author | : Stefani Daniels |
Publisher | : |
Total Pages | : 141 |
Release | : 2018 |
Genre | : Medical care |
ISBN | : 9781683087144 |
Download The Hospital Guide to Contemporary Utilization Review Book in PDF, ePub and Kindle
Author | : |
Publisher | : |
Total Pages | : 240 |
Release | : 1970 |
Genre | : Hospital records |
ISBN | : |
Download The Use of the Hospital Utilization Review Manual Criteria and Record Abstracts for Medical Record Review in a Hospital Committee Setting Book in PDF, ePub and Kindle
Author | : Stefani Daniels |
Publisher | : |
Total Pages | : 194 |
Release | : 2021-10 |
Genre | : |
ISBN | : 9781645351382 |
Download The Hospital Guide to Contemporary Utilization Review, Third Edition Book in PDF, ePub and Kindle
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 | : Peat, Marwick, Mitchell & Co |
Publisher | : |
Total Pages | : 18 |
Release | : 1977 |
Genre | : |
ISBN | : |
Download Reimbursement Manual for Hospital-conducted Utilization Review Activities Book in PDF, ePub and Kindle
Author | : |
Publisher | : |
Total Pages | : 546 |
Release | : 2017-11-27 |
Genre | : |
ISBN | : 9781683086857 |
Download The CMS Hospital Conditions of Participation and Interpretive Guidelines Book in PDF, ePub and Kindle
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.