December 4, 2017
News & Insights

We found out after an observation patient was discharged that one of the procedures performed was an inpatient-only procedure. Can we bill this to Medicare without an official inpatient order on the medical record?

October 2, 2017
Case Management Monthly

Mrs. X, a 30-year-old pregnant mother of two with a supportive husband, is admitted to a Midwest rural hospital. She delivers the baby soon after, and the birth is uneventful.

September 22, 2017
Case Management Monthly

If you’re stressed out, you might be tempted to reach for a glass of wine or a carton of ice cream, but there are more positive ways to manage your stress. Below is a list of healthy strategies from the Centers for Disease Control and Prevention.

September 20, 2017
News & Insights

Q: When should my case managers be screening the patients?

August 30, 2017
Case Management Monthly

Mrs. Jones is a surly 86-year-old patient on day four of her hospitalization.

August 4, 2017
Case Management Monthly

Interventions designed to reduce hospital readmissions are accomplishing their goal from a patient perspective—but not always from a cost savings perspective.

July 28, 2017
Case Management Monthly

In recent years, the federal government has been pushing hospitals to help their patients self-manage chronic conditions. If patients and families aren’t able to sufficiently self-manage their conditions within 30 days of discharge, hospitals may incur reimbursement penalties when these patients are readmitted or need to come back to the emergency department, says Karen Zander, RN, MS, CMAC, FAAN, president and CEO of The Center for Case Management, Inc., in Wellesley, Massachusetts.

July 21, 2017
Case Management Monthly

Below is information from the National Institute of Mental Health outlining the signs and symptoms of depression and how the condition might manifest differently in different patients. The complete guide on depression is available online.

April 7, 2017
Case Management Monthly

Just before the MOON requirement became effective March 8, CMS added another hoop to jump through in an open door forum held February 28.The discussion in that forum forced many organizations to change course at the last minute as CMS announced it would not allow pre-populated check boxes in the free-text field of the MOON designated for describing clinical reasons for the service the patient receives. Organizations that had listened to experts touting the value of adding check boxes with specific rationale to the MOON were forced to revamp the form shortly before implementation.

March 31, 2017
News & Insights

Do we give a MOON letter to a patient who was originally assigned to inpatient status, but then reassigned to observation services when the utilization review committee determined that he or she did not meet inpatient criteria. In this instance, condition code 44 was used and the patient’s status was changed to observation. If we are required to deliver the MOON form in this situation, should it be given to the patient at the same time as the patient is given information on condition code 44? 

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