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AppriseMD Blog

AppriseMD physician advisors provide essential utilization review and denial management services to hospitals

How Does the Two-Midnight Rule Apply When a Traditional Medicare Patient Has No Safe Discharge Plan?

By AppriseMD | February 14, 2022 | Comments Off on How Does the Two-Midnight Rule Apply When a Traditional Medicare Patient Has No Safe Discharge Plan?

For a traditional Medicare patient admitted for observation, it is not uncommon to remain in the hospital longer than two midnights due to non-medical reasons including waiting for a transfer to another facility or family situations. In these cases, the reason the patient remains hospitalized is the lack of a safe discharge plan. Should such […]

White Papers

IPO List Compliance a whte paper from AppriseMD

The financial impact of the IPO list magnified with the rise of CMS-4201-F, giving rise to inpatient reimbursement for all MAO patients who require services designated on the IPO list. Hospitals need to ensure that the proper setting is scheduled when any Medicare or MA patient undergoes a procedure designated on the IPO list, and they should also follow any proposed additions and removals to the list closely to ensure appropriate treatment and reimbursement.

Case Studies

Case Study Readmission Unlinked after P2P

Case Study: Unlinking a Readmission Hospitalization During a Peer-to-Peer Payer Review

By AppriseMD | November 24, 2025 | Comments Off on Case Study: Unlinking a Readmission Hospitalization During a Peer-to-Peer Payer Review

CLINICAL SUMMARY: A 70-year-old patient arrived in the Emergency Department (ED) from an assisted living facility (ALF) as his renal function deteriorated, and he slipped into a severely depressive state. The patient appeared pale and withdrawn, and the ALF staff reported that the patient did not eat or drink for approximately three weeks. Additionally, the […]

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