Corporate Compliance

Review same-day readmission documents

Healthcare Auditing Weekly, September 28, 2004

P>Ensure appropriate Medicare billing and quality patient care by identifying red flags in same-day readmission billing. The OIG looks for the following in its audits of same-day readmissions:

  • Claims for a second patient admission when the patient was transferred within the same hospital

  • Whether the readmission claim should have been a continuation of the initial admission

  • Premature or incorrect discharges

  • Medical conditions that do not require readmission after a discharge

  • Seventy-two hour rule implications

    To learn more about same-day readmissions, order the book "Hospital Auditing and Monitoring: Sample Programs for Key Risk Areas ," published by HCPro, Inc. This binder and CD-ROM are filled with actual audit programs used by auditors and compliance officers in the field.

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