CMS
If a Medicare pt in OBS status is refusing to discharge what form must they receive?
ABN
What does VIDA stand for?
Very Important Discharge Appointment (DCs prior to 11A)
What is the name of the column where you can view DCP updates?
Expected Disch Comment
When do DCAs have to be completed by, with the exception of the weekend?
Within 24-hrs of admission.
When is Course Compass to be completed by?
12.15.22
When does discharge planning begin?
Day of admission
What is the relative value that is assigned to a diagnosis-related group (DRG) of patients in a medical environment?
Case Mix Index (CMI)
What order has to be entered for medically cleared Baker Act patients?
Referral to Behavioral Health
When is it okay to review charts of family members, friends, or neighbors?
Never
The form that OBS non-Medicare patient's receive on admission
HOON
If a Medicare pt appeals a DC outside of the window to appeal, what form do they receive while waiting to hear from KEPRO?
HINN 12
When is the appropriate time to request auth for SNF?
24-48 hrs prior to DC.
How are BPCI-A patients identified in ELLiE?
2 asterisks (**) in front of "DCAD, H/NN"
Which patient's qualify as a CJR Bundle?
THA & TKA (DRG 469 & 470) who are MC FFS
An inpatient Medicare recipient has appealed their discharge to KEPRO. What is KEPRO?
Quality Improvement Organization (QIO)
Public access to emergency services regardless of ability to pay
EMTALA
At what time do we make contact with the NOM/ANM to discuss VIDAs for the next day & where is this documented?
3PM & Under Expected Disch Comment
Where are UR Avoidable Days documented?
Payor Comm -> Bed Days
We do not use the terminology 'Preferred Provider List' because we want to ensure we are abiding by which act?
IMPACT Act
AIDET Stands for:
Acknowledge, Introduce, Duration, Explain, Thank
In order to participate in Medicare reimbursement a hospital must follow federal regulations, what are these called according to CMS?
Conditions of Participation (CoP)
What is the patient satisfaction metric utilized within the health care industry?
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
Updating ADT Codes so ELLiE & CarePort don’t mismatch
Event Mgt -> Update -> DC Disposition
What is MAC (full name + meaning)
Medicare Administrative Contractor | Private health care insurer that processes Medical & DME claims for MC FFS
What is the ADT Code for GIP / IPU?
51