It can be hard to justify the cost of having a case manager on staff 24/7. A lot of hospitals opt to have the case management team work a traditional 8-5 shift. If you are one of these facilities then you should consider after-hours utilization review services. You get the benefit of evidence based reviews on a per case basis without the expense of a full time nurse. Our first level reviews allow you to capture appropriate admission and avoid admissions that might be more appropriate in another status.
Do your case managers spend their mornings doing retrospective utilization reviews for the night before or for the weekend? If so you are not alone. Most small hospital case managers begin their day cleaning up admissions from the night before or from the busy weekend. If your facility uses this approach to utilization management then you are probably missing admissions and exposing your facility to more RAC audits from inappropriate admissions.
There is a Better Way
Let Case Management Innovations handle your after hours reviews and free your case managers up to do their job to the best of their abilities. Facilities that use our service should experience less Condition Code 44 adjustments and reduce their exposure to RAC audits from inappropriate admissions.