Table of contents
I prepared this list of activities hospital based Physicians are an integral part of to address another ‘I do not have any UR experience’ objection.
Take a look:
Does any of this sound familiar?
You are responsible for Clinical patient care practicing evidence based medicineYou provide case management supportYou assist with status determinationsHow about Discharge planning?You are involved in concurrent commercial insurance denial support often involving peer-to-peer discussions with insurance company medical directorsYou oversee Internal patient flowYou lead Family meetingsHow about daily professional interaction with the medical staff ?You are involved in recovery and other audit analysis and defense;Along with case managers you are a part of actual or supervisory appeal writingYou perform peer-to-peer discussions with medical directorsYou may or may not provide oversight of UM committeeYou provide education to the medical staffYou collaborate with other providers on patient care teamHow often do you talk to case management about Clinical documentation improvement (CDI) education.How often do you address coder generated queriesHave you taught residents or trainees how to improve the accuracy of their documentation in order to meet CMS regulatory requirements.
