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Observation vs. Inpatient Case Studies: Master Patient Status Assignment

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Insurance companies and auditors appear to be arbitrarily following the two-midnight rule criteria when denying claims. But, when you master the correct approach to status assignment, you and your team will be able to combat the denials that most likely are occurring in your hospital.


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Price: $229.00

Product Code: AR091318


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Description Biography
 

No doubt you are experiencing this situation at your facility: Insurance companies and auditors are picking and choosing how they want to apply the two-midnight rule to your claims, usually to their own benefit, certainly not yours.

But you can prevail. During this case study-driven webcast, you’ll learn from actual real-world case studies—a straightforward breakdown of status assignment, including how to differentiate between rules that affect Medicare versus non-Medicare patients. You’ll benefit from a refresher course on the controversial two-midnight rule and learn how to risk-stratify your patients into the appropriate status.

You’ll learn the correct approach to status review in order to decrease the likelihood of denials. However, if a denial is inevitable, medical necessity documentation can strengthen the language in the EMR to support a successful peer-to-peer and appeal, if necessary.

Best of all, you can have your questions answered in real-time during this dynamic webcast.

Learning Objectives:

During this exclusive RACmonitor webcast, you will…

  • Benefit from hearing the status reviews of actual cases for inpatient and observation, the lessons from which you can apply to your own situation;
  • Gain a better understanding of the two-midnight rule and how it affects status assignment;
  • Learn about the importance of severity of illness, intensity of service, and risk stratification in non-Medicare patients; and
  • Understand the importance of physician documentation to support medical necessity.
Who Should Attend

Physician advisors, physicians, utilization review committee members, social workers, hospital administrators, hospital compliance, audit, and appeal managers and directors, and RAC coordinators.