North Mississippi Health Services
Tupelo, MS, USA
Review Activities:
monitors individual cases in relation to established criteria, LOS & patient care guidelines
assures patient is meeting level of care criteria & issues denial of care letters as necessary
intervenes as indicated to promote the timely provision of care & utilization of resources
serves as a resource for physicians & nurses in understanding criteria for continued stay & medical necessity
monitors patient outcomes to evaluate clinical & financial effectiveness
reconciles services rendered with patient benefits & communicates with physicians & 3
rd
party payers to assure appropriate reimbursement
Clinical Practice:
collaborates with patient care team to move population along the continuum by effectively planning for continued care as moving to another level of care to ensure all patient needs are addressed
assesses social/emotional factors...
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Assistant & Support
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