Observation Status: Benchmarks and Best Practices
Secure Your Status and Maximize Reimbursements
For what seems like a simple designation, observation status is proving to be a complicated and potentially costly aspect of Medicare admissions. Recently, one hospital on the west coast was forced to recompense the federal government to the tune of $2.2 million because of an observation vs. inpatient discrepancy.
With inpatient admissions criteria more stringent than ever, hospitals must fully understand the opportunities available when applying designations to patients. Implementing best practices in billing, coding, medical necessity and pre-access plans will make sure hospitals are maximizing reimbursement—and covering their history in a safe way to ward against RAC audits.
Join the Case In Point Webinar series as a faculty of frontline practitioners—including a medical director and case management leaders—share their benchmarks and best practices in the vital area of observation status.
Attend from your desktop or conference room. Invite your whole team to attend at one low price of $329 per location. Each registration comes with access to the archived version of the program and the materials until December 31, 2011.
About the Webinar
“Observation status is an administrative classification of patients seen in hospital emergency rooms or outpatient clinics who have unstable or uncertain conditions potentially serious enough to warrant close observation, but usually not so serious to warrant admission to the hospital,” describes the Agency for Healthcare Research and Quality (AHRQ).
Yet despite these defining terms, observation status is far from clear cut. “The designation of ‘observation status’ patients by hospitals is not well understood and has the potential to distort traditional measures of inpatient hospital utilization,” concludes AHRQ.
With the RAC audits now investigating terms of medical necessity involved in decisions about observation status, hospitals, rehabilitation centers and other facilities are at stake for major financial liability due to erroneous coding and reporting.
This Case In Point webinar is aimed at giving healthcare practitioners in facilities the knowledge and know-how they need to adhere to appropriate guidelines, create working models that will best streamline care, and foster best practices to avoid costly audits and maximize reimbursement.
- Provide an overview and background of observation status.
- Define observation status and describe its rules.
- Address the issues at stake with observation-status decisions.
- Describe observation status units, including workflow processes.
- Explore best practices among observation status units and hospital departments.
Our Webinar Will Answer These Questions
- What is observation status?
- How does observation status differ from an inpatient admission?
- Who makes decisions about observation status?
- What are the best guidelines for medical necessity and how should they be used?
- How are RAC audits targeting facilities with regard to observation status?
- What type of dollars are at stake with federal audits?
- What is an observation status unit?
- How can I maximize reimbursement when making observation-status decisions?
- When should observation status be reviewed/changed?
- Who should change observation status?
- What do I need to know about coding and billing errors?
- What is a pre-access program and how does it work?
- What is the role of the medical director?
- What is the role of the case manager?
- How can I implement practical improvements into my department?
- What are the rules about the new regulation requiring direct physician oversight?
- How can I create the best decision-making apparatus for both patients—and the bottom line?
Linda Sallee, MS, RN, CMAC, IQCI
Vice President, Case Management
Inova Health System
Falls Church, Va.
Deirdre Hodges, RN, CCM
RN Case Manager
St. Joseph Mercy Health Center
Hot Springs, Ark.
Jason Napolitano, MD
Medical Director, GONDA Observation Unit
UCLA Health Systems
Los Angeles, Calif.
Marcia Colone, PhD, LCSW, ACM
Director, Care Coordination
UCLA Health Systems
Los Angeles, Calif.
Anne Llewellyn RN-BC, MS, BHSA, CCM, CRRN
Editor in Chief, Case Management Products
Dorland Health, a Division of Access Intelligence
Who Should Attend
- Admission Nurses
- Case Managers
- Clinical Nurses
- Coding Professionals
- Discharge Planners
- Documentation Specialists
- Healthcare Educators
- Human Resource Specialist
- Risk Managers
- Medical Directors
- Medical Providers
- Office Nurses
- Medical Management Supervisors
- Physicians (in all specialties)
- Physician Assistants
- Nurse Practitioners
- Registered Nurses
- RAC Auditors
- Social Workers
Live Webcast Registration – $329
Live Webcast Registration (CMSA rate) – $254
Webcast Recording on CD-ROM – $329
Live Webcast and CD-ROM – $389
For questions regarding the Webinar or to register by phone, contact the Marketing Department at 301-354-1769.
If you are having any technical difficulties or need assistance meeting these requirements, please contact our Technical Support Center at 1-866-709-8255 or click here.
*Dorland Health does not offer any refunds for the webinar. All sales are final.
The live audio is delivered to your location over the telephone or your computer speakers. The Power-Point presentations are presented over the Internet and are available to print out before the program. This is like a talk-radio program with visuals on the Web. You and your team will be able to have a live Q&A with all the speakers.
More details on equipment and connections