North Mississippi Health Services
Iuka, 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 & 3rd party payers to assure appropriate reimbursement
Manages/supervises social work and case management as a team to facilitate discharge planning needs of the patients.
Clinical Practice:
Collaborates with patient care team to move population along the continuum by effectively planning for continued care as...