Complex Medical History

AppriseMD Case Study: Complex Medical History, ICD & Transfer Impact Inpatient Denial Reversal

Case Study: Complex Medical History, ICD & Transfer Impacts Inpatient Denial

An inpatient level of care (LOC), initially denied by a Medicare Advantage payer, was approved after a peer-to-peer discussion involving a stable patient with a complex medical history and condition that required a transfer to a higher LOC. The short stay exemplifies the importance of having physicians with both payer and clinical experience facilitate the […]

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Medical chart documentation

Case Study: Hospital Stay Due to Injury and Complex Medical History

According to the CDC’s National Center for Health Statistics*, there are 130 million visits a year to Emergency Departments, 35 million of which are injury related. Many injury-related ER visits do not result in admission to the hospital, but for those that do, hospital utilization review managers need to provide insurance companies sufficient documentation showing

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