Inpatient Vs Observation Status: Leveraging Untilization Review

Course overview

OBJECTIVES 1. Determine the appropriate use of OBV VS. Inpatient hospital admissions 2. Identify methods to reduce unnecessary hospital admissions using a case management protocol. 3. Discuss methods of leveraging utilization review and case management as a RAC defense. 4. Explain the historical/business basis for the creation and growth of Emergency Department Observation Units. 5. Discuss and apply Medicare rules and policy when utilization review determines that an inpatient admission is not medically necessary or when a hospital should report Condition Code 44.