Observation Status: A Guide to Compliant Level of Care Determinations, Second Edition

Demystify observation status with the only book that explains it from case management’s perspective!

All too often, case managers have to drop everything to wade through confusing CMS and private payer regulations to determine whether a patient meets observation or inpatient criteria. And most case managers have only 24 hours to get the answer right in order to get the reimbursement they deserve.

Save time and protect your bottom line.

HCPro is proud to present the fully updated second edition of our best-selling book, Observation Status: A Guide to Compliant Level of Care Determinations. This new edition is completely revised to bring you the most current CMS regulations and MS-DRG changes.

Bonus! This book now includes a companion CD-ROM loaded with customizable tools and forms you can put to work to beat your observation status confusion today.

This new resource delivers a practical approach to understanding the convoluted world of observation status. By examining updated regulatory guidelines, management of multiple payers, the implications of OIG investigations, and strategies to prepare for Recovery Audit Contractors (RAC), this book defines a case manager’s specific role in observation status. It also explains how staff education and an effective team approach—involving nurses and physicians—can result in optimal reimbursement.

Take a look at what’s covered in the new edition:

• Fully customizable forms and tools on the accompanying CD-ROM
• Case studies that illustrate real-life challenges and solutions
• New material on collaborating with physician advisors and preparing for the RAC program
• Medicare rules for observation status and how to implement an effective and compliant policy
• Multiple payers’ rules for observation status and how to implement a payer-specific policy
• Using internal and external data to determine improvement opportunities
• Dos and don’ts for Condition Code 44

Who will benefit from this book?

• Case managers
• Directors of case management
• Directors of nursing
• Nurse managers
• Medical directors
• Physician advisors