CRCR Part 3(Time-of-service)
Emergency Medical Treatment and Labor Act (EMTALA) (Ans- Requires hospitals to provide a medical screening examination and any needed stabilizing treatment to every person presenting at an ED and requesting treatment. The screening examination must not be delayed to inquire about the patient's method of payment or health insurance status.
Newborn Patient Processing:
(Ans- Newborns are always registered as newborn admissions. The mother's registration information is used until the baby is named, then the newborn record is separated. Newborns born outside the hospital and subsequently transported to the hospital are separately identified according to the required UB-04 coding rules. If both parents have health plan coverage, staff must contact both health plans to determine if they follow birthday or gender rules for COB.
Attending Physician (Ans- The physician who wrote the order for service and is the physician in charge of the patient's care for a specific period of time. Also referred to as the admitting physician.
Two-midnight rule (Ans- Patients receiving care for 2 consecutive midnight's then are subsequently admitted as inpatients. CMS requires the use of occurrence 1 / 2
code 72 to denote the date span of continuous OP hospital services that preceded the IP admission.
Conditions of Admission (Ans- Standardized form signed by all patients that is used to inform the patient about the admission and conditions that must be agreed upon for the hospital to provide care.
Important Message from Medicare (Ans- Informs Medicare beneficiaries of their right to dispute a hospital's discharge decision and how to do so.
Medicare Outpatient Observation Notice (MOON) (Ans- Notifies Medicare patients who are in OP status for more than 24 hours why they are in OP status and discuss implications of that status.
Advance Directive (Ans- A living will which states the patient's treatment wishes but does not name a patient advocate.
Case Management (Ans- Monitoring the progression of high resource consumptive cases to help ensure effective utilization of resources during the care of the patient to maximize patient outcomes.
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