The CMS 1500 and the UB04 are two types of claims forms used to submit charges for reimbursement. The UB04 (also called CMS 1450) is mainly used for facility claims, such as hospitals, surgery centers, and nursing homes. They cover both inpatient and outpatient charges, along with any associated with diagnostics, supplies, and lab work. This forms shows the “resources used” by the facility. When this form is submitted electronically, it is called the 837-I, with the “I” standing for Institutional.…
A Burnout is a form of chronic stress related to ones' job. Burnout occur most frequently in nurses who work long hours in high stress areas, such as critical care, oncology, or burn units. Symptoms of burnouts include fatigue, frequent colds, headaches, and insomnia. Mental symptoms may include decreased ability to solve problems and unwillingness to face problems and change. Nurses who suffer from burnout may quit their job or change jobs outside of the nursing profession.…
According to the Association of American Medical Colleges (AAMC), about 81% of medical school grads are walking away with an average medical school debt of $183,000. Because of the high incomes physicians make, many people (new medical school graduates included) think that their loan repayment is something they can easily handle. However with ever increasing costs and significant declines in physician reimbursements from Medicare and Medicaid, some doctors are finding trouble paying off loans without accruing tons of interest. Physicians still accepting Medicare and Medicaid patients are expected to see reimbursement rates drop as much as 21 and 43 percent, respectively.…
Nurse practitioner reimbursement is a complex configuration that includes regulatory factors both at the state and federal levels. As late as 1990, direct Advanced Practice Registered Nurse’s (APRN) reimbursement by Medicare was available only in rural areas and skilled nursing facilities (1). In 1997, President Clinton instituted the Balance Budget Act that expanded the reimbursement for APRN’s to all geographical and clinical settings allowing the direct Medicare reimbursement to NP’s, but at 85% of the physician reimbursement rate (2). Although the expansion of nurse practitioners scope of practice was intended to meet the needs of a shortage of family physicians, it has left gaps in care for many of the most defenseless populations.…
The University of Michigan Health System is one of the largest health care facilities in the world. The facility is also referred to as the University of Michigan Hospital. It is one of the largest hospitals in the state of Michigan, as well as a premier academic medical center. Michigan Health System has a vision of creating the future of health care through discovery, as well as to become the national leader in care, education, biomedical innovation, and health care reform (Regents, 2015). An important aspect of quality assurance is utilization management.…
Looking at the two documents, there were several differences between the two documents. The first difference is rule number two, which states that friends of patient living close to the hospital were obligated to bring in change of clothes for patient. The second difference was noted in rule number three, where patients were to leave their valuables to the woman superintendent, before heading to their admitting floor within the hospital. The third difference was the limiting the amount of visitors that were allowed to see patients. The fourth difference which is not only precise, besides, confining, is rule number ten which states, and I quote “Every patient shall retire to bed at 9 p. m. from First May to First November, and at 8 p.m. from…
It can also affect many school activities with having to start later and end sooner since the day ends faster. Teens shouldn’t be affect with these possibilities of not being in an activity because the later changes. There has been a non-scientific survey that has reported 50 percent of parent that have agree or are undecided with the new time changes and 60 percent of staff agreed with the change. I believe that parents think it’s right for their children to start later or earlier because of the evidence that they have been provided about their children academic improvement. Staff had worked in school with the children and they might also believe it is right because it can change their school education but they don’t understand that it can affect the different schools because it will not be the same times for all…
Disproportionate Share Hospitals (DHS) which once served as a safety net to the uninsured and underinsured is under threat to provide the population it was designed to help. Drastic budget cuts to this vital lifeline of the health care system could affect the health care needs of this vulnerable population. At the same time, there must be increased restrain to rein in the costs. We cannot talk about DSH, without first discussing the role of safety net hospital play in the healthcare system. Per Bailit at el, ...”…
The following strategies relate to the implementation of the hourly rounding: a. The human resource department and the financial department will, within the first two weeks, carry out assessments to determine the exact human resource and financial requirements of implementing the hourly rounding b. The human resource department will, within the next one month, design and initiate training programs to educate the nursing staff on the importance of hourly rounding and prepare them for the change process c. The finance department will, within the next one and a half months mobilize funds to ensure that sufficient financial resources are available to facilitate implementation d. The team leaders will, within the next one month, collaboratively design measures to facilitate effective hourly rounding. Such measure includes explanation scripts and whiteboards to foster more focused rounding…
Avoidable readmissions come at a great cost to patients/residents, healthcare providers, and taxpayers, a $25 billion cost to be exact. This is the estimated amount that avoidable readmissions cost the nation on a yearly basis and is one of the largest contributors to the enormous growth in national health care costs. Readmissions are the result of several difference aspects from incomplete treatment, poor post-acute care, lack of coordination in discharge planning, or even the unavailability of social supports. Recently the Center for Medicare and Medicaid (CMS) began penalizing hospitals for avoidable readmissions as part of the hospital readmission reduction program supported by the Affordable Care Act (ACA). Now that these penalties have become the “law of the land”, CMS is moving onto the next phase of in care continuum, post-acute-care, specifically skilled nursing facilities (SNFs).…
The proposed bill will not only benefit healthcare in a positive way, but will greatly impact patients as well. First, patients will get the help they need, and will less likely be readmitted to an inpatient facility. As a result, the overall cost that a healthcare organization would have to pay for hospitalization would be decreased. Secondly, patients will receive further care by having an on-call case manager on standby if needed.…
Mental health is a serious issue in the state of Kentucky, and millions of people are affected by mental illness worldwide. Not only does mental illness affect the individual, but family members and friends can become distressed for fear of the individual harming themselves or others. The key to preventing harm is to establish a way for individuals to receive appropriate care for their mental illness by means of therapy. Mental health therapy can help an individual cope with stressors and relieve anxiety to promote a more healthy way of living. Whether an individual needs outpatient therapy or hospitalization depends on many factors, thus initiating a mental health assessment is important in determining therapy measures.…
The third shift or the night shift starts from the mid- night and ends in the wee hours of the day which is from 12 A.M to 8 A.M. Work done in shifts can certainly yield the best results for the companies, but various studies have pointed out that working in night shift or rotational shifts can have detrimental effects on the health of the employees. Working in night shifts in particular can be an impediment in living a healthy life. It is normally observed that most of the individuals…
As a result of spending extra time with one patient, the provider will then have less time for other patients scheduled that…
Ambulatory and inpatient settings both provide therapeutic and diagnostic care to patients with a distinct difference in the level and scope of care. Ambulatory care and outpatient care are interchangeable terms. Ambulatory (outpatient) care; this term refers to care either therapeutic or diagnostic in a one day setting. Ambulatory care does not require overnight stay in a hospital. Ambulatory care can be given in a medical facility other than a hospital.…