The battle lines have been drawn between observation and inpatient status, as hospitals jockey for appropriate reimbursement for comparable patient care. And this standoff is creating an opening for a surge of potential Medicare audits.
Auditors — lean and mean from slim audit pickings during the coronavirus pandemic — are hungry, looking for the low-hanging fruit created when administrators, physician advisors, and case managers aren’t on the same page, putting hospitals at even greater risk for more denials, lower reimbursement, and longer lengths of stay. It’s a conundrum documented in a nationwide survey undertaken by Sound Physicians and reported on by Chris Shearer MD, MPH, chief medical officer in the organization’s Physician Advisor Services section.
To learn more about the extent of recent auditing activities, listen to the next live edition of Monitor Mondays, coming your way on Monday, Aug. 16 at 10 a.m. EST.
Other segments to be featured during the live broadcast include the following: