freefalling

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1. UR Interview coming up, need some questions answered please.

   freefalling replied to nursestaci's topic in Case Management

   Who benefits from a top-notch UR program? Everyone! And who suffers when a UR program is subpar? Everyone! 1. The patient. Getting the right care at the right time at the right level makes for a healthier person, moving through the continuum of ...

2. Case Management Scenario Questions

   freefalling replied to SPJJMommy's topic in Case Management

   Too late to edit my previous post, so I'll add here: (and this is still assuming the interviewing company is a WC insurer) On second thought, #1) may be that they would want you to do an official denial as "other payer primary/responsible", or deny a...

3. Case Management Scenario Questions

   freefalling replied to SPJJMommy's topic in Case Management

   I agree, need some clarification - your questions sound as if they are coming from the payer side - is your interview with an work comp insurance company? If so, I worked WC/Ins many years ago, and the first things that popped into my head were thes...

4. Learning Interqual

   freefalling replied to CABG patch kid's topic in Case Management

   Yes, of course it is not a CM’s job to make someone meet criteria, but it is a CM/URRN’s job to identify when they do - which can, at times, be a difficult process. I respectfully disagree that one should “NOT look around”. If someone is new to the ...

5. Learning Interqual

   freefalling replied to CABG patch kid's topic in Case Management

   Hello! Not sure what kind of unit/floor you’ll be working, but yes eventually things do begin to feel intuitive after you’ve seen X-number of the same types of conditions/patients. It does take time, and just when you think you’ve got it all figured ...

6. Advice please: Withdrawal of feeding tube

   freefalling replied to Clubsingr28's topic in General Nursing

   Just to muddy the waters... What IF, instead of a 79 yr old woman s/p CVA with no long-term hope of an independent life with - limited mobility (requiring hoyer lift in/OOB into a recliner where she watches TV, listens to her classical music and read...

7. Advice please: Withdrawal of feeding tube

   freefalling replied to Clubsingr28's topic in General Nursing

   This was my initial thought as well – an untreated UTI can go south fast, especially in an elderly patient. 79 yr old ladies tend not to eat or drink that much to begin with, and if her TFs have just been DC’d, it’s not likely that her nutritional st...

8. Falsification of medical records

   freefalling replied to psunsg1975's topic in Case Management

   A comparison between your employees’ documentation and hospital records is a slippery slope indeed. You’re assuming that a hospital CM/SW documents the details of every conversation had with an insurance CM. In reality, with staffing as it is, facili...

9. anti xa lab draw question

   freefalling posted a topic in General Nursing

   hello, I'm new to the whole anti xa lab protocal and have a question. I had a nurse at work tell me one thing and another nurse tell me something else.. When do we actually adjust the dose? Do we do it from the time the lab was drawn or from the time...