Medicare Utilization Review for Clinicians

Course Provider
Learning Objectives
Comply with Medicare coverage requirements for observation
Evaluate circumstances when an Advanced Beneficiary Notice of Non-Coverage (ABN) would be appropriate and useful for patients in observation
Assess inpatient orders for compliance with Medicare requirements
Comply with the two-midnight benchmark
Comply with Hospital Conditions of Participation for Utilization Review determinations
Evaluate the advantages and disadvantages of Condition Code 44 and self-denial processes from a clinical and revenue cycle perspective