Medical Necessity Documentation II

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Did you know? All health insurance carriers are increasingly scrutinizing your belief that the patient in front of you really requires inpatient admission to your hospital.

Please be sure to use strong action words/phrases like:
• ACUTE
• ACUTE ON CHRONIC
• DECOMPENSATED
• EXACERBATION
• WORSENING
• FAILED OUTPATIENT TREATMENT
• PATIENT IS IMMUNOCOMPROMISED
• The CURB-65 SCORE is . . .
• The PNEUMONIA SEVERITY INDEX is. . .
• The TIMI or HEART SCORE is . . .
• The SOFA SCORE is . . .

Please make sure you update the pre-populated physical exam template in your EMR at the time you see the patient!

Download the complete tip, Medical Necessity Documentation II.