SPOTLIGHT: Documentation, evidence-based admission guidelines help hospitals fight payer audits
Post-payment audits by Medicare and private insurers often look at the medical necessity of admitting patients through hospital emergency departments and find that many patients should have been held for observation rather than admitted. Writing on the Healthcare Exchange blog hosted by clinical systems vendor Picis, Dr. Jeff Wadja, VP of clinical services at Picis subsidiary Lynx Medical Systems, suggests that evidence-based guidelines for admission and rock-solid documentation of patient comorbidities and ancillary tests are strong defenses against such audits. Read between the lines and see where IT comes in. Blog
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