Untreated mental conditions can prevent patients from properly managing physical health, thus causing the patient to be readmitted to the hospital, which is why case managers should coordinate mental and physical treatments.
Experts expect the RACs to begin auditing medical necessity this summer. Case managers may be asked to play a large role in appealing medical necessity denials because of their involvement in level-of-care determinations. To help case managers, we asked Medicare appeals experts to explain the case manager’s role in the appeals process.
Sarah Bush Lincoln Health Center in Mattoon, IL developed a productivity incentive plan for their coders and transcriptionists. For the hospital, the bonus plan serves as a retention and marketing tool, not to mention it has increased productivity, and the staff members appreciate it, too.
