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UR Question

asked November 21, 2013 | 21 followers | follow

Scenario: The patient admitted with an IP order for inability to care for self, etc. on a Sunday. Review on Monday with PA (UM member) results in observation determination. If attending physician will not write order to change to observation (with a code 44), do you issue an admission HINN? Is it ok that it would be issued 24 to 48 hours after admission? I can’t seem to find information describing a timeframe it would have to be given (other than when the notice is effective based on issuance before or after 3pm on the day of admit). Does anyone know of a time limit for issuing the admission HINN? (Assume it is not an option for a 2nd UM committee member to review the case.) I would appreciate your input!

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