Hospitalized, but Not Admitted: Admission Status

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Inpatient versus Observation: Practical Points • Days do matter, and a proper status needs to be in place as soon as possible • We can’t bill for services until the proper status order is written • Changes patient’s bill and benefits dramatically • Early management of patient expectations • This all plays into the bottom line, financially and in terms of clinical ratings • The “23-hour rule” is irrelevant
Recovery Audit Contractors (RAC) and Medical Necessity
Page 1 and 2: Hospitalized, but Not Admitted: Adm
Page 3 and 4: What do these people have in common
Page 5 and 6: Objectives • Introduction and Def
Page 7 and 8: Medicare 101 • Medicare for Inpat
Page 9 and 10: Inpatient versus Observation • Ob
Page 11 and 12: Inpatient versus Observation: Inter
Page 13: Inpatient versus Observation: Pract
Page 18 and 19: RAC Audits • UW Policy: all chart
Page 20 and 21: Medical Necessity • A test may be
Page 22 and 23: How to Navigate Observation Status
Page 24 and 25: Medicare Benefit Policy Manual, 1:1
Page 26 and 27: Examples • S: Knee pain O: Knee p
Page 28 and 29: Same patient, different documentati
Page 30: References • www.medicare.gov •

Hospitalized, but Not Admitted: Admission Status

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