Making an appropriate decision about patient status is never simple. Even for experienced physician advisors, case managers, and utilization reviewers, the challenge of determining which patients should be inpatient and which should be outpatient with observation services remains perpetually challenging. Not only can determining medical necessity be difficult but considering the differences between payor rules based on your hospital's contracts is an ever-evolving situation. Additionally, when it has been decided a patient's status should change from inpatient to outpatient, are you confident your team can compliantly follow-through with the steps of Condition Code 44? After this webcast, you'll be certain they do.
Register now and learn strategies to ensure patients are in appropriate status from the start of the hospitalization to the time of discharge from physician advisor and case management expert Juliet Ugarte Hopkins, MD, CHCQM. She will ensure you fully comprehend the nuances of patient status assignment and precisely how to carry out Condition Code 44. You will be confident that you can immediately apply your new understanding to your department's workflows after attending this RACmonitor webcast.
Register now to gain access to "Demystifying Inpatient vs. Observation and the Condition Code 44 Process."
Why This is Relevant:
Hospitals and health systems must follow the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (CoP) in order to bill for services supplied to Medicare beneficiaries. One portion of this regulation involves Condition Code 44, a process which includes the change of patient status from Inpatient to Outpatient (with or without Observation services). While Condition Code 44 has been mandated for over fifteen years, the complex nature of the process continues to vex and confuse members of case management and utilization review teams across the country.
- Gain the ability to describe what steps need to be taken to compliantly carry-out a Condition Code 44.
- Understand how patients with similar clinical conditions but different insurance plans can be in different statuses due to contracting rules.
- Learn the most efficient ways to train new case managers/utilization reviewers to assess patients for appropriate status.
- Understand how your physician advisor can best work with your case management/utilization review team to ensure patients are in appropriate status from the start of the hospitalization to the time of discharge.
- Understand how your physician advisor can collaborate with and educate your medical staff about correct patient status determination.
Who Should Attend:
Physician advisors; hospitalists; physicians; case managers; case management directors; utilization review directors, managers and professionals; social workers; and hospital administrators.
Webcast Access Privileges: Only one login is allowed per webcast purchased. Discounted pricing for additional registrants is available. For more information about webcast pricing and requirements, click here.