Two Midnight Rule and Admission Certifications: Tips, Tricks and Traps

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Are You Ready For The Two Midnight Rule? Help is here.

Even after a year of coming into force, there are still many questions about the Two Midnight Rule and how to interpret it. For hospitals and health systems trying to grasp the foundational elements of the Two Midnight Rule, this session will be devoted to the new rule and CMS’s guidance since the rule’s issuance.

In this informative session, expert speaker David M. Glaser will share tips for physicians and staff on applying the Two Midnight Rule and properly completing certifications for inpatient admissions. He will also discuss frequently asked questions and CMS’s responses on this topic.

There has been a great deal of discussion about the Two Midnight Rule. But do you know how the new rule can help you win appeals from short stay denials that occurred before the rule was issued? This session will explain it all, and more!

Topics covered in the session:

  • Practical suggestions for physicians to document patient status
  • Understand when time starts to count for purpose of the rule
  • Why commonly used utilizations tools like InterQual and Milliman should play a limited role in admission decisions
  • Know how both the transferring and receiving hospital should handle patient status
  • Identify how missing physician certifications can create overpayment risks
  • Comprehend how expected changes in the patient (death/transfer/leaving against medical advice) affect patient status
  • Case discussion on unexpected discharge
  • How to use the Two Midnight Rule to improve your chance of winning appeals of cases that were denied before the rule was issued

Presentation snapshot:

  • Insights on new inpatient admission rule
  • Medical Review Requirements
    • Physician acknowledgement
    • Physician’s order and certification regarding medical necessity
  • Physician certification of admission
  • Frequently asked questions (FAQs) and CMS’s response on the same
    • Physician expectation
    • Screening
    • Time calculation
    • Transfers
    • Discharge
    • Who may make the order?
    • Who is “knowledgeable about the patient’s hospital course”?
    • What must the order say?
    • Must the order be signed?
    • What about verbal orders?
    • Are standing orders okay?
  • Documentation when making the admission decision and discharge
  • What’s the test again?
  • What if the procedure is elective and scheduled?
  • What if the surgery is cancelled after admission?
  • And more.

Who should attend? CEOs, CFOs, compliance officers and anyone who would deal with potential overpayments or investigations in medical facilities such as hospitals and clinics

Order Below or Call 1-866-458-2965 Today

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About Our Speaker

David Glaser - Hospital Coding Guidelines Expert

David M. Glaser is a shareholder in Fredrikson & Byron’s Health Law Group. David assists clinics, hospitals, and other healthcare entities negotiate the maze of healthcare regulations, providing advice about risk management, reimbursement, and business planning issues. He has considerable experience in healthcare regulation and litigation, including compliance, criminal and civil fraud investigations, and reimbursement disputes. David’s goal is to explain the government’s enforcement position, and to analyze...   More Info
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