Best Practice Utilization Management: 10 Tips for Success

Utilization management was the first role applied in acute care case management models.  It was first known of as utilization review but has evolved into something much more comprehensive.  Today it encompasses elements of res...

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Documentation Requirements for DME in the Medical Office

Durable Medical Equipment (DME) is used to treat conditions and injuries that patients are recovering from.  One way a patient can receive a DME is when the office purchases the DME from a manufacturer or distributor and then dispe...

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Acute Care Case Management: Roles, Functions, Models and Staffing Ratios

The Centers for Medicare and Medicaid Services (CMS) has instituted  linkages between cost and quality through value-based purchasing and other cost-saving measures such as payment penalties for high readmission rates. These change...

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Priming Acute Care Reimbursement: From DRGs to Bundled Payments

This program will provide a foundation of knowledge and understanding of the DRG system used as the structure for reimbursement under the Medicare and Medicaid programs. Included in this will be a review of the DRG relative weights, cas...

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Care Coordination: Strategies for Managing Cost and Length of Stay

This program will review the elements that most greatly impact on cost and length of stay by focusing on care coordination as one of the key strategies for successful reductions of these metrics. Care coordination, as one of the main ro...

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