TECHNIQUES TO IMPROVE GIVING A REVIEW

Course overview

OBJECTIVES The provider will be able to: 1. Identify six elements to prepare for an inpatient review. 2. List three potential obstacles encountered by the inpatient reviewer 3. Explain three steps to obtain an outpatient or benefit determination authorization. OUTLINE A. INTRODUCTION B. INPATIENT REVIEW 1. Case Study 2. Obstacles faced by Hospital Reviewer C. OUTPATIENT AUTHORIZATIONS D. OUTPATIENT SERVICES 1. Ambulatory Surgeries 2. Outpatient Diagnostic Testing 3. Rehabilitative Therapies 4. Home Health 5. Durable Medical Equipment 6. Benefit Determination Requiests E. SUMMARY