title: Audits highlight need for documentation.
abstract: The Centers for Medicare & Medicaid Services' "Probe and Educate" initiative to determine hospitals'compliance with the two-midnight rule makes it clear that case managers must review physician documentation as well as medical necessity. The Medicare Administrative Contractors are focusing on short stays when physician documentation doesn't support the expectation of a two-midnight stay. They're looking at flawed admission orders, and when the orders to admit are issued by a practitioner who does not have admitting privileges at the hospital. Another area of focus is physician statements without documentation of the reason for the need for inpatient treatment.
mesh_terms: D019090:Case Management; D014487:Centers for Medicare and Medicaid Services, U.S.; D004282:Documentation; D006801:Humans; D007345:Insurance Claim Review; D007349:Insurance, Health, Reimbursement; D014481:United States