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Unlike conventional AI models that rely solely on their training data, RAG combines the power of large language models with real time information retrieval from your organization’s specific databases and documents.
Note: CMS documents how each ICD-10 code can be either a CC or MCC here. They would submit their charges post-discharge and be reimbursed. While many doctors naturally believe their patients require the highest level of care, DRGs provide an objective assessment. What role does a patient’s DRG play in CareGauge?
Patients unplanned returns to the hospital after discharge drive up costs, disrupt recovery, and reflect gaps in care. Under HRRP, hospitals received financial penalties if their readmission rates exceeded the national average a move that drove greater attention to discharge protocols and transitional care.
By using Success, Effort, Emotion, and Trust (SEET) as measurements for every PX processfrom appointment setting to careplans to paymentsthe healthcare community can expand its potential for providing excellent care. No touchpoint is too small for inclusion.
Hospices should also be concerned about care coordination. The Centers for Medicare and Medicaid Services (CMS) is ramping up survey scrutiny for hospice this year, training surveyors to focus on interdisciplinary group careplanning and coordination of care as part of an emphasis on meeting four core Conditions of Participation.
By incorporating care coordination practices such as risk assessment, careplanning, care transitions, patient education, patient navigation, telehealth, and home visits, care coordination teams can bring in resources to help patients navigate health concerns that span physical, behavioral, and social risk factors and needs.
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