Hospitalized, but Not Admitted: Admission Status
Hospitalized, but Not Admitted: Admission Status
Hospitalized, but Not Admitted: Admission Status
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Inpatient versus Observation: InterQual<br />
• “The Gold Standard in Evidence-Based Clinical Decision<br />
Support”<br />
• Used by CMS, 3700 Hospitals, 300 Health Plans, the<br />
military, others<br />
• Originated due to demands created by birth of Medicare<br />
and Medicaid; these programs led to guidelines, which<br />
were very subjective and not evenly applied<br />
• InterQual is a checklist…<br />
• Physician judgment can trump guidelines if the judgment<br />
portion/documentation is clear
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