Readmission

Doctor performs labs in emergency department.

Case Study: Readmission Linking Denial Overturned After P2P

Case Study, Denial Management, Peer-to-Peer / By

CLINICAL SUMMARY: A 79-year-old male patient arrived in the emergency department (ED) complaining of weakness, extreme lethargy and the inability to eat for the past three days. The patient’s past medical history included prostate cancer s/p resection with metastases to the bladder and lumbar spine on antiandrogen, hypothyroidism, hypertension, hyperlipidemia, CAD s/p stent placement x2, […]

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Linking hospitalizations AppriseMD

Case Study: Readmission Linking for Hospital Stays Reversed

Case Study, Denial Management, Peer-to-Peer, Readmission / By

CLINICAL SUMMARY: Recently, physicians admitted a 73-year-old patient with an extensive medical history twice within an 8-day period. The patient required inpatient level of care (LOC) for both hospitalizations. The patient was hospitalized with pneumonia during the first inpatient stay, and the second inpatient hospitalization addressed exacerbated congestive heart failure (CHF). The patient arrived for

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