Patient Status Essentials for Case Managers

INTERACTIVE
HC Pro
27 mins

Patient Status Essentials for Case Managers

INTERACTIVE
HC Pro
27 mins

Course Overview

This course will focus on the challenge of ensuring accurate patient status assignments. While it is physicians who are charged with determining patient status in the hospital, the case manager plays a critical role in helping to ensure these decisions are correct. During utilization review, case managers often review patient status, ensure it meets criteria, and identify whether documentation supports medical necessity. This course will cover how to determine whether a patient status assignment is accurate. It will also provide an overview of the elements that must be present in physician documentation to support medical necessity and patient status, and discuss the impact of the 2-midnight rule on this documentation. The course will additionally note potential challenges in complying with the 2-midnight rule and strategies to overcome them. Finally, it will outline how to create a successful audit process—one designed to find potential patient status problems—and how to form strategies to establish corrective actions that prevent future status errors.


Learning Objectives

At the completion of this course, the student will be able to:

  • Identify the challenges related to assigning correct patient status
  • Discuss the role of the case manager in ensuring correct patient status assignments and in supporting physicians’ status determinations
  • Outline the changes brought on by the 2-midnight rule
  • Identify potential compliance challenges with the 2-midnight rule
  • Discuss the importance of a strong audit process and how to put one in place

Duration

27 minutes

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