Controlling Costs and Changing Patient Care?

Controlling Costs and Changing Patient Care?
Author: Committee on Utilization Management by Third Parties
Publisher:
Total Pages: 330
Release: 1989
Genre: Medical
ISBN:

Utilization management brings patient-level and system-level concerns together and represents a new nexus of relations among pagers, practitioners, hospitals, and patients. This report bears both on generic issues of knowledge and values, and on issues specific to current organizations and procedures for influencing patient care decisions. For private and public policymakers. Annotation copyrighted by Book News, Inc., Portland, OR

PSRO

PSRO
Author: Arthur D. Little, Inc
Publisher:
Total Pages: 488
Release: 1973
Genre: Medical
ISBN:

PSRO

PSRO
Author: Sharon Van Sell Davidson
Publisher:
Total Pages: 378
Release: 1976
Genre: Hospital care
ISBN:

The Hospital Guide to Contemporary Utilization Review

The Hospital Guide to Contemporary Utilization Review
Author: Stefani Daniels
Publisher:
Total Pages: 0
Release: 2015-04-16
Genre: 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