Establishing an Effective Preadmission Certification Program in a Naval Medical Center.
Abstract
As resources for Department of Defense health care delivery diminish, the Naval Medical Center Portsmouth, Virginia must stretch funds while providing quality health care to eligible patrons. One cost containment mechanism is third party payer preadmission certification for patients requiring hospitalization. This case study found the process was fragmented due to inadequate education of clinical staff; physical and artificial barriers to effective communication and implementation, and conflicting department-specific operating procedures. The addition of a preadmission certification processor improved third party reimbursement and interdisciplinary communication, resulting in better patient care. Further research is required to determine the efficacy of the preadmission certification process as a utilization management tool. Alternatives like total case management should be considered to facilitate active collaboration of the delivery team members and encourage appropriate use of medical facilities and services, improve the quality of care and maintain cost-effectiveness on a case-by-case basis.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 1994
- Accession Number
- ADA293420
Entities
People
- Paul M. Hoffman
Organizations
- Academy of Health Sciences