There is a trend in healthcare to review one day stays for medical necessity. This is most common when there is a differentiation between observation services and inpatient stays.

While medical necessity is certainly a cause for concern in terms of compliance there is also an issue relating to how certain services are billed and collected. At Auditech we have found that many patients “cross over” midnight and are automatically admitted rather than staying as observation or status outpatient.

With certain services such as electrophysiology and cardiac catheterizations there is a significant opportunity to lose percentage based reimbursement as opposed to per diem reimbursement.

 


Please contact us if you have additional questions or to learn more.

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