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Written by Carol Howard, VP of Clinical Strategy As Medicare Advantage (MA) continues to grow, hospitals have faced growing challenges in navigating complex policies, payer friction, and financial pressures. Recently, I interviewed industry experts who discussed these issues in depth during a live recording of The Better Care Podcast.
In the bustling corridors of a hospital or a private clinic, healthcare professionals often face a daunting avalanche of paperwork. Agendas are filled to the brim, and stacks of patient records teeter on desks, demanding attention. It’s no secret that healthcare document scanners have revolutionized medical documentation.
“This saves physicians what we call ‘pajama time,’ when they finish their work after hours, and the patient gets the full attention from the physician and full eye contact,” he said. Deborah Vaughan, a patient at the hospital, said she appreciates being able to look her doctor in the eye while talking about her health.
This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. There can also be state variations with additional regulations regarding documentation and coding requirements that layer on top of federal guidelines.
Innovation, AI, and the Future of PatientCare At the ViVE conference leaders in digital health shared their experiences and forward-thinking strategies for improving patientcare, streamlining operations, and integrating technology into clinical workflows. I’m really interested in the care journey space.
In our efforts to empower hospital clinicians to provide better care by having real-time transparency to cost and benchmark utilization data, we’ve learned that one of the core code systems that defines modern hospital resource management – Diagnosis-Related Groups (DRG) – is misunderstood or even unknown.
The top reasons reported for leaving were burnout, feeling undervalued, and a high patient-to-nurse ratio. However, hospital layoffs are another culprit driving experienced nurses from their profession. Getting rid of seasoned nurses will not solve the hospital’s financial problem.
Use documentation for more than just patientcare. Not only can written notes of encouragement or praise for your coworkers boost morale, but documentation of conflicts or questionable events can sometimes protect you from dismissal or lawsuits. Written communication with management staff is a powerful tool.
Social Admission vs. Medical Necessity In healthcare, the term “social admission” signifies instances where patients find themselves admitted to a hospital primarily for non-medical reasons. These can range from the need for custodial care to a desire to avoid personal challenges.
Enrolling in medical training programs in Charlotte, North Carolina , helps trainees gain the high-demand skills needed to navigate real-world challenges in hospitals, clinics, and other medical environments. These essential skills provide a career advantage and are key to making a positive impact on patientcare.
Health Populi’s Hot Points: Physicians have become more familiar with various AI use cases that are helping reduce administrative burden, bolster cognitive processes, and streamline scribing, documentation, and notes.
Suppose your hospital or clinic is considering adopting a new clinical documentation solution. Cutting-edge clinical documentation solutions – like speech-to-text medical dictation and AI medical scribes – can save providers hours weekly. EMR-independent documentation tools don’t lock you into a single system.
Whether you’re a seasoned nurse or a new grad joining the fray, you’ll find golden insights and proven tips to increase your productivity, reduce stress, and, most importantly, still deliver outstanding patientcare. Another challenge is the high patient load. Shall we begin?
Specifically, we’ll discuss how AI can: Automate Clinical Documentation Support Clinical Decision-Making Triage Patient Communication Diagnose Medical Images Automate Routine Tasks Each topic includes a Software Spotlight, highlighting practical tools that illustrate AI’s impact in real-world settings.
Medical assistants care for patients and help manage administrative tasks within hospitals, clinics, and other healthcare venues. A Medical Assistant’s Duties with Patients A considerable amount of a medical assistant’s time may be dedicated to patientcare.
These measures play a fundamental role in hospital management, financial planning, and patientcare optimization. By understanding and leveraging GMLOS and ALOS, hospital executives can improve operational efficiency and patient outcomes.
They’re skilled professionals who support physicians, nurses , and other healthcare providers in delivering quality patientcare. This knowledge is essential for accurately handling patient records, insurance claims, and other healthcare-related documents.
Key Applications of AI in Healthcare Here are some of the most important ways in which AI is already impacting hospitals and clinics: Diagnosing Medical Images – AI analyzes medical images effectively, which can improve diagnostic accuracy. The biggest concern may be data privacy and security.
Many participants have a role to play in the revenue cycle, and at each stage they must employ their specialized knowledge of how that patient interaction and service is documented in the patient’s health record. How Clinical Documentation Integrity Affects Revenue. How Clinical Documentation Integrity Affects Revenue.
Key Takeaway Electronic Health Records (EHRs) have revolutionized nursing documentation, making it more efficient, accurate, and accessible. Telehealth and telemedicine technologies allow nurses to provide remote patientcare, monitoring, and education, which has been particularly helpful during the COVID-19 pandemic.
As mental health demand continues to grow exponentially , it is equally important for mental health providers to optimize their billing practices to ensure fair and timely reimbursements, enabling them to continue delivering high-quality patientcare. Strategies to improve your mental health reimbursements 1.
Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. Undercoded Complex Hospital Admissions. Otherwise, patients might not appear as sick as they really are,” said Bowman.
Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. Undercoded Complex Hospital Admissions. Otherwise, patients might not appear as sick as they really are,” said Bowman.
Mobile apps for physicians can enable communication with patients and other providers, enhance medical education, inform clinical decision-making, and streamline documentation. ” – App Store Review Popular Alternatives: TigerConnect (secure hospital team messaging), OhMD (HIPAA-compliant patient texting).
A ventilation system proves to effectively reduce hospital infections, maintain indoor air quality while following specific Standards. The design and installation of utilities to meet patientcare and operational needs are critical.
While the document sets out a vision for integrated, community-focused care, it provides little in the way of clear guidance for GP practices, leaving them uncertain about how they fit into the evolving system. The publication of the Neighbourhood Health Guidelines for 2025/26 has once again left general practice in the dark.
Here’s a brief explanation: Credentialing with private insurance is often insurer-specific, meaning each company may require different documents or processes. Having these documents ready and in one location can help you stay organized. Organizations like CAQH make it easier to streamline standard documentation.
Understanding the Challenges in Claims Processing Errors in medical claims processing have traditionally posed significant challenges for hospitals, insurers, and patients alike. By streamlining this process, providers can reduce administrative burdens, focus on patientcare, and achieve faster reimbursements.
One of the measures that has sparked significant debate amongst Practice Managers is the plan to give doctors 20 each time they consult a specialist, either by phone or email, under the so-called advice and guidance (A&G) scheme to see if there is an alternative to hospital visits and treatment. In a pickle Is it just me?
All these devices provide increased mobility through the facility, enabling them to develop a new and easy-care point depending on the location of every patient. It will bring down the scope of human errors, for instance, administering medications and documentingpatient data.
Key competencies and attributes of nurse leaders include the following: Understands the correlation between a strong team and high levels of patient quality and safety. Encourages feedback and works to solve problems related to patientcare, patient safety, budget, and staffing.
Yet, they continue to frustrate clinicians with poor UI/UX and largely fulfill a primary role as a system of record to document claims submissions. Example: Custom Workflow for Clinician Onboarding A common challenge in healthcare is the complexity of onboarding new clinicians, especially in large hospital networks.
While your work experience section is typically the most important part of the document, adding volunteer experience in your resume can help you plug gaps in your work experience and include skills that would otherwise be missing.
Damon Broyles of Mercy Technology Services for an episode of The Better Care Podcast , and throughout this interview it became evident that numerous innovations are shaping the future of the industry. Healthcare providers can monitor patients’ vital signs and intervene promptly if concerning trends emerge.
Automated clinical documentation solutions like Conveyor AI and DAX Copilot are gaining momentum. These software programs are possible because of recent advances in generative AI, which allow computers to draft clinical notes accurately by listening to the doctor-patient interaction.
It’s essential to regularly assess and optimize your EHR workflow to ensure you’re providing the highest-quality patientcare while remaining profitable. Four steps to optimize your EHR workflow Hospital CIOs often allocate budget line items for EHR optimization.
Improved Medication Adherence: Regular virtual check-ins enhance patient compliance with treatment plans. Reduced Hospital Stays: Faster diagnosis and management plans lead to shorter hospital stays. Mobile Apps: Patients can access telehealth services via smartphones and tablets, in addition to desktops.
Quality Control: Ensuring the accuracy and reliability of test results through careful analysis and adherence to protocols. Record Keeping: Documenting test results and maintaining accurate patient records for future reference. Works behind the scenes, contributing to the diagnosis and treatment of patients through lab work.
Knowing that their patients don’t understand what they are saying or the healthcare education they offer can add stress to the nurses’ workday and place obstacles all the way through the patient journey. Should hospitals and health care providers work on overcoming language barriers?
3) high levels of collegiality and mutual trust At its base, quality patientcare requires collaboration, and that collaboration cannot take place without high levels of trust-both in clinical judgment and behavior. Those circles of trust act as shock absorbers for the inevitable surprises and events that crop up in the care process.
Promoting a culture of knowledge and awareness of current standards of wound care. Providing consistent, evidence-based care and thorough documentation. Reducing the number of hospital- or facility-acquired pressure injuries, which are nonreimbursable. Building your reputation as a wound care center of excellence.
“This is unlike anything we have seen before in terms of its size and scope,” said Clif Gaus from the National Association of Accountable Care Organizations, which played a crucial role in uncovering and drawing attention to the alleged fraud. This would ensure that only eligible providers deliver Medicare services.
Shelise Valentine, RNC, MSN, C-EFM, CPPS, CPHRM, is the Director of Clinical Education, Healthcare Risk Advisors, part of TDC Group and chairs nursing, co-chairs obstetric and simulation initiatives, and directs risk management and obstetric education for insured hospital clients to improve patient safety and reduce malpractice risk.
In a recent Relias webinar , Sue Grafton, RN, BSN, CWON, Clinical Support Manager at McKesson Medical-Surgical, said that nurses might sometimes feel uncomfortable discussing the financial side of patientcare decisions. You can provide consistent care if you have accurate documentation of your patient’scare at the hospital.
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