article thumbnail

Navigating the Complexities of Social Admissions in Healthcare

EvidenceCare

Social Admission vs. Medical Necessity In healthcare, the term “social admission” signifies instances where patients find themselves admitted to a hospital primarily for non-medical reasons. However, these admissions come with their own set of difficulties, particularly in the realm of Medicare coverage and reimbursement.

article thumbnail

Preparing for CERT Audits and Practicing Compliant Documentation

EvidenceCare

This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. This section delves into the specific criteria and expectations set by CERT audits, emphasizing the need for meticulous attention to detail and documentation accuracy.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

Documentation Challenges and Payer Friction As MA plans focus on profit margins, hospitals are encountering increased payer friction, denials, and administrative burdens, particularly around the CMS Two-Midnight Rule. Document why you believe that. She provides education to physicians to document their internal monologue.

Hospital 130
article thumbnail

New Insights on Medicare Advantage Plans and The Two-Midnight Rule

EvidenceCare

This also means that the medical record must support the reasonableness of the clinician’s admission decision regardless of the total time spent in the facility. Compliant documentation has also become more challenging. This highlights the necessity for hospitals to implement clear and robust compliance documentation practices.

article thumbnail

Optimizing Process and Document Automation in Healthcare

Electronic Health Reporter

The article Optimizing Process and Document Automation in Healthcare appeared first on electronichealthreporter.com. While many industries are still taking the first steps on their transformation journeys, most healthcare organizations sit a few stages ahead on this path.

article thumbnail

Connect Care Scheduled Downtime and Spring Upgrade - Thursday March 13, 2025, 00:30-04:30

Connect Care Bytes Blog

PRD SRO (the read-only copy of the production environment) will be available during this outage; PRD SRO is accessible from any computer used for documenting in Connect Care regularly. DURING DOWNTIME Check with Unit Clerk/Charge Nurse to confirm processes for ordering, documentation, and patient movement.

article thumbnail

All User Bulletin: Admission and Discharge Navigator Optimizations

Connect Care Bytes Blog

Enhancements to Core Admission and Discharge Navigators Connect Care uses "Navigators" to help prescribers complete complex workflows when key tasks are easy to forget. Core "Admission" and "Discharge" navigators organize review (e.g., orders) and documentation (e.g., problem, medication and allergy validation), action (e.g.,