NA1785 - Utilization Review: Understanding Admission Status

Course Provider
Learning Objectives
Define observation and inpatient status
Explain the articles of participation and the requirements for the utilization review
Explain the two midnight rule and three midnight rule
Describe the criteria for medical necessity and what entities define those criteria
List the consequences for facilities, physicians, and patients regarding which admission they are classified.
List the alternative choices to hospitalization for Medicare beneficiaries
Discuss how family members can be paid by the government to be caregivers
Explain the palliative care plan for patients