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Medfield Afterschool Program Medfield, MA 0. All rights reserved. YP, the YP logo and all other YP marks contained herein are trademarks of YP LLC and/or YP affiliated companies. AT& T, the AT& T Logo and all AT& T related marks are trademarks of AT& T Inc. All other marks contained herein are the property of their respective owners. Medfield Public Schools - MHS Home. Mission Statement. Medfield High School in partnership with family and community promotes both integrity and excellence in scholarship and citizenship for all learners. Medfield High School is committed to: Challenging Academics for All.
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Utilization Review FAQ // ACEPFAQ 1. What are the issues and concerns? Medicare's inpatient prospective reimbursement system uses hospital submitted ICD- 1. I PREFACE This manual h as been written as a practical guide for implementing a basic drug utilization review (DUR) program in a hospital setting. Diagnosis Related Group (DRG), which ultimately determines payment for the inpatient admission. Each DRG has a known mean length of stay (LOS). Medicare is concerned about overpayment and appropriateness of the admission. Utilization review (UR) nurses work behind the scenes to maximize the quality and cost efficiency of health care services. Utilization review is a type of case. Sierra View District Hospital's (SVDH) utilization review (UR) process originates in the Case Management (CM) department. They are responsible for the case review and. What Utilization Management Is and How. Utilization Management Program. As a result, Medicare and a state's Quality Improvement Organization (QIO) monitor hospital discharge data and specifically target short hospital stays. As a result, hospital health information management (HIM) and utilization management (UM) staff closely monitor the medical necessity of inpatient hospital admissions and short inpatient hospital stays. People searching for Utilization Review Nurse Certification and Training Program Info found the following information and resources relevant and helpful. Psychiatric Hospital Survey Module. Composition of Utilization Review Committee A process for monitoring the use and delivery of services, especially one used by a managed care provider to control health care costs. Their efforts can put pressure on emergency department physicians to make sure that each inpatient admission from the ED is medically necessary and will pass fiscal intermediary or Medicare Area Contractor (MAC) scrutiny. These are listed in the various medical necessity screening tools. In some cases the use of observation status might be an alternative to an immediate inpatient admission. FAQ 2. Observation admission? Different jurisdictions may use different tools. The main criteria relate to intensity of service and severity of illness. From both the hospital's and payer's perspective, it is the admitting physician's decision whether or not to admit the patient. The criteria for inpatient hospital admission vs. Documentation by the treating physician becomes key in determining the intensity of service and the severity of illness. This includes the emergency department record. If a patient does not meet inpatient criteria but it is uncertain if they can be safely discharged home, it is not automatically assumed that the patient should be placed in observation or treated as an outpatient. There are cases when inpatient criteria are not met but the patient clinically requires an inpatient admission. In these situations, physicians and case managers look at the complete picture of the clinical presentation to determine the need for hospitalization. In addition, there are cases when inpatient screening criteria are met and the payer denies payment because the documentation, in their view, did not support the necessity for inpatient care. Observation payment? National Government Services, the MAC for CT, IL, NY, and WI, recently posted their policies for making clinical and payment decisions regarding observation. In this process a nurse or physician reviews the record for clinical documentation to support the hospital admission and/or payment. For example, this may happen when a patient is admitted on Friday night and on Monday, upon review of the admission by UR, the admission is reclassified as Observation. Medicare expects this to occur infrequently and has established specific rules for making the status change when an inpatient does not meet the hospital's inpatient criteria. Importantly, the status change must be made prior to the patient's discharge. Below are some additional requirements: The hospital has not already submitted the inpatient claim to Medicare. The Utilization Committee makes the decision and the physician concurs. The physician's concurrence with the UR committee is documented in the patient's record. The UB0. 4 outpatient bill is submitted with condition code 4. Medicare does not recognize a separate patient status called . When Condition Code 4. Even in Condition Code 4. HCPCS code G0. 37. Hospital observation service, per hour) for the time period during the hospital encounter prior to a physician's order for observation services. Like all hospital outpatient services, observation services must be ordered by a physician and the reporting requirements specific to observation services are discussed in detail in the Medicare Claims Processing Manual (Pub. Chapter 4, Section 2. The clock time begins at the time that observation services are initiated in accordance with a physician's order. While hospitals may not report observation services under HCPCS code G0. Condition Code 4. An observation status patient may be admitted to an inpatient status at any time for medically necessary continued care, but the patient can never be retroactively changed from observation to inpatient (replacing the observation as if it never occurred). If a patient is admitted to the hospital from observation, inpatient medical necessity screening criteria must be met at the time of the hospital inpatient admit (the criteria cannot be carried over from the time the patient was placed in observation). FAQ 5. It is important that emergency physicians have an awareness of the hospital's concerns regarding short inpatient hospital stays, have information about the hospital's medical necessity criteria for inpatient admissions, and consistently use good documentation practices. While technically it is the admitting physician's responsibility to assure compliance in these circumstances, the emergency department documentation can go a long way towards providing supporting information for the urgent or emergent condition of the patient. Some specific things the emergency physician can do: Use observation stays appropriately. CMS identifies failure to do so as one of the major reasons why patients are admitted for medically unnecessary short stays. Invite someone from utilization management to talk with the emergency group about medical necessity admission criteria. Have them explain what tools and criteria (with exceptions) the hospital uses to verify medical necessity for observation and inpatient admissions. If there is a problem with admission denials from the ED, ask about the feasibility of basing a case manager in the ED to implement an admissions review process prior to patient admissions (this may be only a temporary need). In collaboration with the hospital, consider making decision support software available to assist emergency physicians in determining if an observation or inpatient stay is most appropriate. Document the full clinical picture of patients' severity of illness in the ED. This includes any social conditions, co- morbidities, debilities and risk factors that affect your decision to admit. Document why the patient is being admitted to the hospital. Be aware that an order for . Likewise, an order for . How are inappropriate admissions monitored by Medicare? Medicare utilizes the RAC. What is the Medicare comparative data report called PEPPER? The PEPPER (Program for Evaluating Payment Patterns Electronic Report) is a report that summarizes Medicare claims data statistics for one provider, comparing the provider. The PEPPER produced, distributed and supported by TMF Health Quality Institute through a contract with the CMS Office of Financial Management. Providers can use this data to focus their monitoring and auditing efforts and track improvement over time and to compare their performance with other hospitals in their state, MAC jurisdiction and nationwide. PEPPER is available for short- term acute care hospitals, long- term acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, hospices, partial hospitalization programs and skilled nursing facilities. PEPPER will be available to home health agencies. For more information visit http: //pepperresources. Disclaimer The American College of Emergency Physicians (ACEP) has developed the Reimbursement & Coding FAQs and Pearls for informational purposes only. However, ACEP cannot guarantee that the information contained in the FAQs and Pearls is in every respect accurate, complete, or up to date. The FAQs and Pearls are provided . Payment policies can vary from payer to payer. ACEP, its committee members, authors or editors assume no responsibility for, and expressly disclaim liability for, damages of any kind arising out of or relating to any use, non- use, interpretation of, or reliance on information contained or not contained in the FAQs and Pearls. In no event shall ACEP be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Specific coding or payment related issues should be directed to the payer. For information about this FAQ/ Pearl, or to provide feedback, please contact David A. Mc. Kenzie, CAE, Reimbursement Director, ACEP at (9. Ext. 3. 23. 3 or dmckenzie@acep. NEWS FLASH TRANSITION SOUND EFFECT + DOWNLOAD - Free Sound Effect For You. Vote for us @ https: //gleam. EDVXt/mato it takes 2 seconds, ill do a giveaway with the stuff if we win, thanks in advance. NEWS FLASH TRANSITION SOUND EFFECT + DOWNLOAD - Free Sound Effect For You. 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