Hospitalized, but Not Admitted: Admission Status
Hospitalized, but Not Admitted: Admission Status
Hospitalized, but Not Admitted: Admission Status
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RAC Audits<br />
• UW Policy: all charts reviewed at admission for<br />
appropriate status (utilization review or UR)<br />
• RAC gets ~400 closed charts every ~45 days; we prescreen<br />
submissions<br />
• Submitted charts are reviewed/possibly denied by RAC<br />
• Some charts reviewed for coding (correct DRG), some<br />
for medical necessity of services provided (MN)<br />
• Vast majority of our denials are for MN<br />
• Denials can be appealed; multiple levels with strict<br />
deadlines<br />
• No reimbursement collected on final denials
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