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Engagement Awareness
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Hospitals are Acute Care & ERs are for emergencies

2/15/2018

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Hospitals are classified as acute care centers for treatment of acute conditions, so I can go home and recoup/rehab. Emergency rooms (ERs) are part of Emergency Departments (EDs) as the point of entry to be stabilized for admission as an inpatient or go immediately to surgery. If it is not life threatening or severe, I should first go to an Urgent Care Center (UCC). 
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Hospitals are reviewed by the Center for Medicare and Medicaid Services (CMS)/insurances and will receive denials of payment if there was not a medical necessity to be there. It is important to partner with clinicians and Case Managers when it is ambiguous regarding the correct, safe and proper treatment for Inpatient versus an Outpatient, because "Insurance claim denials cost hospitals $262 billion annually", and so, hospitals should never be treated as a hotel or doctor office.  
Hospitals are reviewed by the Center for Medicare and Medicaid Services (CMS) regarding denied reimbursement if I come back in less than 30 days with the same condition, and so it is important to make sure that I am receiving the right code associated with my admitting and discharge primary diagnosis for accuracy of my care. The Care Manager can assist if there are any questions regarding admission & discharge coding of diagnosis in my medical record.
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  • DHC
  • AWARE
    • why is it needed
    • about us
    • I wish I had known
    • resources
    • education benefits
  • Blog
  • ART
    • Healing Home & Repose
    • Healing Moment & Touch
    • Healing Peace
    • Healing Gift & Hope
    • Healing Love & Ripple
  • Books
  • PARC
    • Services
  • PACE
  • Contact