Patient Status Training Toolkit for Utilization Review
Kimberly A.H. Baker, JD, CPC
Toolkit contains 5 handbooks and 5 pocket cards.
Make sense of medical necessity, condition codes, and patient notices while reviewing cases.
The Patient Status Training Toolkit for Utilization Review is a quick-reference handbook and pocket card that will serve as an everyday guide to utilization review (UR).
The handbook is a practical guide that UR committee members can keep at their desk to refer to as they work through UR processes. It offers an overview of regulatory requirements for UR in addition to access to downloadable case studies and Medicare resources that can help guide committee members through real-world cases.
The pocket card is an easy-to-digest reference that uses a flow chart and helpful tips to walk UR committee members through the process of verifying patient status determinations. If the or UR committee member reviews a case and determines the patient’s status must be changed, the pocket card will offer guidance on this process through days one and two, if applicable.
Who should read this book?
- Utilization review professionals
- Utilization review committee members
- Case management professionals
- Quality management professionals
- Social workers and professionals
- Compliance officers
- Health information management professionals
- Finance professionals
- Data analyst professionals
- Patient financial services professionals
- Denials management professionals
- Medical doctors
- Doctors of osteopathic medicine
- DDSs or DMDs (dentists)
- DPMs (podiatrists)
About the Author
Kimberly Anderwood Hoy Baker, JD, CPC, is the director of Medicare and compliance for HCPro. She is a lead regulatory specialist for HCPro's Revenue Cycle Institute and is the lead instructor for HCPro's Medicare Boot Camp®—Hospital Version and Medicare Boot Camp®—Utilization Review Version. She is also an instructor for HCPro’s Medicare Boot Camp®—Critical Access Hospital Version. She is a former hospital compliance officer and in-house legal counsel, and has 10 years of experience teaching, speaking, and writing about Medicare coverage, payment, and coding regulations and requirements.
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Published: March 2016