Compliance
The form that OBS non-Medicare patient's receive on admission
HOON
The way in which we provide handoff to TMs.
CM Handoff Template in ELLiE
The timeframe for concurrent & retro closeouts to be completed
Concurrent – When pt is walking out the hospital ; Retro - >48-hrs for SOC of services
How is the OBS Rate determined?
OBS DCs / OBS DCs + IP DCs
Information CMT brings to huddle
Retro Closeouts, Missed Concurrent Closeouts & Compliance Letters Due
The form I must receive if I appeal my DC through KEPRO outside of my appeal window.
HINN 12
All patient’s displaying a hx or present SI must undergo this assessment
CSSRS
What is the process now for obtaining Patient Choice
CarePort -> PC -> Add to Cart -> Share to Pt via text / email / printout
What is the process of OON identified pt’s
Notify pt’s not in network + document & RNCM submit clinicals to payor every 2 days
Minimum daily time presence on unit outside of MDRs / DCAs
30 minutes
The 1135 waiver is tentatively scheduled to lapse on
07.16.22
What does EMA stand for?
Emergency Medicaid Alien
Tools used to determine if services are clinically indicated & provided in the appropriate LOC
InterQual & MCG
Different Admission Statuses
IP / OBS / SS
Information MSW brings to huddle
# of DCs & DCAs, Pt’s who have Consults & >7 Day Documentation
The (4) types of HINNs
HINN 1
HINN 10
HINN 11
HINN 12
Documents to be submitted to KEPRO if appeal filed
Last IMM / DND / Clinicals (3 Days)
Where are Avoidable Days documented
Discharge Milestones
Correct way to submit DCS Request (Subject Line / Recipients / Info)
DC support request - Doe, J.
Mgr / Dept Sec. / DCS Team / DCS Mgr
Pt Info / ELLiE Screenshot + Request of svcs
Information RNCM brings to huddle
# of OBS / IP / CSR, Clinical Requests & Pt’s Who Need Monitoring
Public access to emergency services regardless of ability to pay
EMTALA
Name 5 out of 10 BPCI-A HC participates in
Sepsis, Renal Failure, UTI, PNA & Resp Infections, Cellulitis, COPD / Bronchitis / Asthma, Stroke, Seizures, GI Hemorrhage & GI Obstruction
Updating ADT Codes so ELLiE & CarePort don’t mismatch
Event Mgt -> Update -> DC Disposition
What is PPS (full name + meaning)
Prospective Payment System
Fixed amount of reimbursement based off DRG
What information is provided to unit ANM / Charge RN at Evening Huddle
Identified VIDAs for the next day