Managing patient status plays a critical role in proper compliance, correct reimbursement, and stabilizing inpatient payments for the hospital. Medicare Advantage Plans must also follow the Two-Midnight rule and inpatient only list. Understanding the intricacies of these rules and the CMS guidance will be critical to ensure plans are compliant with their obligations to patients and providers.
Short-stay auditor Livanta has also concluded their first year of audits, with over half of denials for admission related to the circulatory and digestive systems. Don’t become a target or leave money on the table—have confidence in the UR determinations you and your facility are making.
The Medicare Boot Camp®—Utilization Review Version answers all your questions about navigating the CMS website and finding Medicare requirements. You will be able to find answers to your questions long after the Boot Camp is over.
And we have THREE different formats for this important education:
In-person Boot Camps provide the opportunity for you to join your peers for two days of open discussion, learning, sharing, and networking.
Our live instructor-led virtual classes run roughly 4 hours each day, allowing you to stay productive on those days while also setting aside time for valuable education.
This informative class covers various aspects of utilization review, including medical necessity determinations, documentation requirements, observation, inpatient orders and inpatient certifications. It equips you with the tools and strategies needed to ensure compliance with Medicare regulations while ensuring proper reimbursement and managing utilization appropriately.
Stay up-to-date and fully understand the complex rules and guidelines for Medicare reimbursement and utilization review processes.
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