Prevention of hospital payment errors and implications for case management a study of nine hospitals with a high proportion of short-term admissions over time

Professional Case Management

Volumn 13, Issue 5, 2008, Pages 264-274

  Hightower, Rebecca E ^a  

^a Louisiana Health Care Review Inc   (United States)

Author keywords

Billing; Documentation; Inpatient; Medicare; Payment

Indexed keywords

ARTICLE; CASE MANAGEMENT; ECONOMICS; HEALTH SERVICE; HUMAN; INSURANCE; LENGTH OF STAY; MEDICAL RECORD; MEDICARE; METHODOLOGY; NURSING CARE; PROSPECTIVE PAYMENT; QUALITY CONTROL; REIMBURSEMENT; TIME; UNITED STATES;

CASE MANAGEMENT; FORMS AND RECORDS CONTROL; HEALTH SERVICES MISUSE; HUMANS; INSURANCE CLAIM REPORTING; INSURANCE, HEALTH, REIMBURSEMENT; LENGTH OF STAY; MEDICARE; NURSING CARE; PROSPECTIVE PAYMENT SYSTEM; QUALITY CONTROL; REIMBURSEMENT MECHANISMS; TIME FACTORS; UNITED STATES;

EID: 58149131585     PISSN: 15297764     EISSN: 15390675     Source Type: Journal    
DOI: 10.1097/01.PCAMA.0000336689.93070.4e     Document Type: Article

References (8)

1. Glondys, B. (May 2003). Ensuring legibility of patient records. AHIMA Practice Brief. Chicago: American Health Information Management Association.
2. Smith, C. M. (2001, March). Documentation requirements for the acute care inpatient record. AHIMA Practice Brief. Chicago: American Health Information Management Association.
3. The Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services. Billing procedures, sections 411, 414.3,415, 455, 460. In Medicare hospital manual. Atlanta, GA: Author. Retrieved from http://www.cms.hhs.gov/Manuals/PBM/itemdetail.asp?filterType= none&filterByDID=99&sortByDID=1&sortOrder=ascending&itemID= CMS021912&intNumPerPage=10
4. The Centers for Medicare and Medicaid Services. U.S. Department of Health and Human Services. Medicare conditions of participation for hospitals, Subpart C, Basic hospital functions, Section 482.24, p. 488, Medical record services (c)(1). Atlanta, GA: Author.
5. The Centers for Medicare and Medicaid Services. U.S. Department of Health and Human Services. Medicare hospital manual, Coverage of hospital services, Sections 210, 216, 230.6, 290. Atlanta, GA: Author.
6. The Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services. (Proposed and Final Rules) Changes to the Hospital Outpatient Prospective Payment System and CY 200X Payment Rates, Addendum E, HCPCS Codes that would be only payable as inpatient procedures (inpatient list), in the Federal Register, annually in August and November. Atlanta, GA: Author.
7. The Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services. (2005). Utilization management and compliance, and documentation and compliance. In Hospital Payment Monitoring Program Compliance Workbook (Rev. ed., pp. 25-46). Atlanta, GA: Author.
8. The U.S. Department of Health and Human Services. (1998). Office of Inspector General (OIG) Compliance Program Guidance for Hospitals, Compliance Program Elements (pp. 14-15). Author.