Spss In Nursing

Being diagnosed with rare and chronic diseases has placed many patients and their families under a lot of stress. Many patients and their families are overwhelmed with the amount of clinical information that is delivered to them by providers and nurses. In addition, many providers do not have adequate time to spend with patients to help them to understand their diagnoses and treatment options. Therefore, a large number of patients feel confused and miserable about their conditions. They are lost in the sea of information, do not know where to cling to, and how to ask for help to understand their illnesses, especially with older patients.
SPs can help to close that gap of patient care processes. SPs will support patients by educating patients …show more content…
SPs will collaborate closely with providers’ office to obtain patients’ medical information including diagnoses, ICD-9, ICD-10, CPT codes, histories and physical, progress notes, assessment plans, lab results, and so on; then, SPs will communicate with insurances to initiate prior authorizations, appeals in case of denials for specialty medications. Once medications are approved by insurances, SPs will help patients to start the necessary treatments in timely manners by assisting them to relieve the high copayments, proactive counseling and educating patients, and promoting patients’ adherence to treatment through their courses of …show more content…
Therefore, knowledge of insurances for pharmacy and medical benefits are essential. For examples, chemotherapy or transplant medications dispensed from SPs are eligible for reimbursement from Medicare part B only when patients are not admitted to skilled nursing facilities (SNF). HIM professionals must screen patients’ statuses before allowing medications to be sent out to prevent non-reimbursement