Performance Monitoring for Short Stay Inpatient and Observation Services
Hospitals and health systems consistently struggle with the appropriateness of their short stay admissions and the utilization of observation status. These challenges have significant implications in terms of compliance and revenue. Incomplete documentation and inconsistent application of admission criteria could lead to increased audit activity and recoupments. The over-utilization of observation could result in reduced revenues or increased compliance risks.
The CBIZ Difference
CBIZ combines its clinical, compliance and financial reimbursement expertise to offer a comprehensive performance improvement and monitoring solution. Our melding of data analytics, revenue cycle optimization and clinical best practices has created a unique service that helps hospitals and health systems reduce risk and regulatory compliance issues. The S20 Monitor improves the application of admission processes, ensuring that patients are assigned to the appropriate level of care, resulting in optimized revenue for providers.
Key questions providers need to ask themselves:
- How are we minimizing risk?
- Are my observation and inpatient short stay cases trending positively?
- How do our observation and inpatient short stay volumes compare to our peers?
- Is our medical necessity documentation for the Two-Midnight Rule and observation patients improving?
- Is our observation and inpatient short stay risk related to specific diagnoses, physicians or service lines?
- Are we over-utilizing observation and is that resulting in lost revenue?
This unique service offers answers to these questions through a number of solutions.
- Data Analytics: We provide a comprehensive quarterly risk reporting package that includes a dashboard and reports by service type, length of stay, observation volume, diagnosis and provider. The reports provide ongoing trending, benchmarking and peer comparison data.
- Clinical Medical Necessity Review: Our clinical review of select short stay and inpatient and observation cases to determine if the submitted documentation supports medical necessity requirements for the level of services provided.
- Case Management Assessment: We assess the facility processes to determine the appropriateness and timeliness of patient status assignment.
Contact our team for more information!
Jeff Lampman at 609-918-0990 ext 118 or click here to email
Adam Abramowitz at 609-918-0990 ext 169 or click here to email
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