Sample Form: Ensuring Patient Status Is Correct for Medicare, Other Payers

Here’s a form to help ensure physicians document patient status, including inpatient or observation, for surgeries. “This form fulfills all the items on the wish list of the hospital utilization review staff,” said Ronald Hirsch, M.D., vice president of R1 RCM. “It indicates the HCPCS code of the planned procedure, which is necessary to determine the correct status for many payers; it provides prior authorization information to ensure the payer has approved the procedure; and it provides a clear status designation with need for a bed if appropriate. A signed form also serves as an order for inpatient admission, and that meets the regulatory requirement for a signed admission order that becomes active when the surgery begins.” Contact Hirsch at rhirsch@r1rcm.com.

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