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CMS Utilization Review Standards

CMS Utilization Review Standards

CMS Utilization Review Standards

Sue Dill Calloway, RN, MSN, JD
Sue Dill Calloway, RN, MSN, JD
on behalf of Relias Academy

$30.00 $ 30.00 $ 30.00

$30.00 $ 30.00 $ 30.00

$ 30.00 $ 30.00 $ 30.00
$ 30.00 $ 30.00 $ 30.00
Normal Price: $30.00 $30.00

Review:

Launch date: 13 Aug 2018
Expiry Date:

Last updated: 11 Oct 2018

Reference: 191769

This course is no longer available

Exam is embedded in the course
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Description

Utilization review (UR) allows hospitals to monitor and protect themselves and their patients against unnecessary readmissions. It is important to be compliant with the UR standards to avoid penalties from the Recovery Audit Contractors and the Office of the Inspector General. During this program, attendees will learn about CoPs for UR, the new outpatient MOON forms, state QIOs, and the two-midnight rule. Our expert will provide plans for hospitals to implement in order to comply with the UR standards and prevent unnecessary readmissions.

Objectives

Describe CMS CoPs for Utilization Review.
On completion of this course, the learner will be able to describe CMS CoPs for Utilization Review.
Explain the medical necessity of documentation by the physician in the medical record.
On completion of this course, the learner will be able to explain the medical necessity of documentation by the physician in the medical record.
Describe what is required for a UR committee.
On completion of this course, the learner will be able to describe what is required for a UR committee.
List 3 revised tag numbers.
On completion of this course, the learner will be able to list 3 revised tag numbers.
Sue Dill Calloway, RN, MSN, JD

Author Information Play Video Bio

Sue Dill Calloway, RN, MSN, JD
on behalf of Relias Academy

Sue is a nurse attorney, medico-legal consultant and long-time educator for nurses, physicians, and other healthcare providers. She is a frequent speaker and is well known across the country in the areas of healthcare law, risk management, and patient safety. She has authored over 100 books and hundreds of articles. For AHC Media, she authored Cracking the Code: Understanding the CMS Hospital CoP Standards on Anesthesia.

Ms. Calloway received her Bachelor of Arts, Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Jurisprudence from Capital University in Columbus, Ohio. Additionally, she is certified in healthcare risk management by the American Society for Healthcare Risk Management and is the first in the country to be certified in CMS regulatory compliance.

Current Accreditations

This course has been certified by or provided by the following Certified Organization/s:

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