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Perspectives

Is Your Facility Too Lenient on Physician Certifications?

by ExcelasJanuary 26, 2018
Problems with documentation in skilled nursing facilities (SNF) often lead to claim denials that can negatively impact cash flow and make these facilities susceptible to audits. According to findings in the 2017 Comprehensive Error Rate Testing report, one of the most common errors in medical reviews is missing or insufficient physician certification and/or recertification statements. [More]

Long-term Care | Medical Review | Regulatory

11 Risk Factors for Infections Among the Elderly

by ExcelasAugust 2, 2017
Infections in long-term care (LTC) facilities are associated with higher rates of morbidity, mortality, rehospitalization, extended hospital stays, and substantial expense. Urinary tract infections (UTIs) are among the most common infections seen in LTC facilities. For these reasons, many medical malpractice lawsuits involve patients who were treated for an infection of some kind. [More]

Health and Aging | Issues in LTC | Long-term Care | Medical Review

ARE YOU USING THE CORRECT TERMINOLOGY FOR PRESSURE INJURIES?

by ExcelasNovember 22, 2016
The National Pressure Ulcer Advisory Panel (NPUAP), a not-for-profit organization of pressure injury experts, recently made changes to the terminology and staging system used for the identification and assessment of pressure ulcers. [More]

Issues in LTC | Legal Nurse | Long-term Care | Medical Records | Medical Review

RAC Audits: The Calm Before the Storm

by ExcelasMay 23, 2013
The Center for Medicare and Medicaid Services (CMS) recently announced that healthcare providers would begin to see a decline in the number of additional documentation requests (ADRs) they receive, beginning in June 2013. There is one implication and one opportunity to be found in this announcement. [More]

Long-term Care | Medical Records | Medical Review | Regulatory

Medical Legal Analysts: The Credentials and Qualifications That Matter Most

by ExcelasApril 18, 2013
    Medical Legal Analysts.  Legal Nurse Reviewers.  Medical Analysts.  Although the titles may vary, it’s the skills that matter.  There’s a lot of discussion in the industry about what courses to take, what certifications to obtain, and how best to get a foot in the door doing medical analysis for the legal industry.  Companies that recruit for these positions often have one simple—but very significant—objective: Finding a candidate with clinical experience. Many times, when recruiters look to fill analyst positions, they’re not necessarily looking at the alphabet soup after a candidate’s name, although it is necessary to have a nursing degree.  A candidate’s competitive advantage is his or her clinical experience.  The recruiter wants to see medical knowledge and practical experience that will enable the candidate to zero in on crucial information in the medical record and assess the quality of care.  This is the candidate’s most essential asset, the foundation upon which everything else rests. So, what exactly makes up “the total package” for legal medical analysis companies?  For some, the baseline requirements for a medical legal analyst position are a nursing degree, a minimum of 8 to 10 years of clinical experience, and stellar writing skills.  Beyond that, recruiters may look for a person with sharp detective skills—a puzzle-solver, an analytical thinker and an objective observer, with a little bit of techie thrown in for good measure.  And as for desirable intangible skills, it’s really about passion—a passion for telling the story of a resident’s care from myriad details and facts, a passion for excellence, and a passion for positively impacting how healthcare is delivered. Certifications and training courses are generally both viewed positively.  But the basic skills of nursing and writing are the real foundations of a medical legal analyst’s success, and can function as a foot in the door.  The more practical experience candidates have, the more successful they (and their clients) will be.  Ultimately, a passion for finding the key details hidden in the medical record, matched by the ability to blend analytical thinking with clear and concise writing, will put a candidate ahead of the rest.   If you would like to learn more about Medical Legal Analysts, talk to an expert at Excelas.  

Legal Nurse | Medical Review

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