This is not news for many in the healthcare profession as they face the challenges of billing rules and regulations and the sometimes obscure idiosyncrasy – but as you can see form this piece on NBC for many patients this is a surprise and a costly one at that
Hospitals are told that they “have to” use this status (Under Observation) if the patient doesn’t meet a host of criteria for “Admission” all being driven by a series of guidelines that are publicly available although not well known and much of it in response to the RAC audits
All this is set to get worse with the “Two Midnight” rule (you can see some guidance here and some of the issues on this here)
