Supporting Medical Necessity in the Inpatient Setting

medical necessityPYA Consulting Manager Lori Baker facilitated a workshop, “Supporting Medical Necessity in the Inpatient Setting,” at the Florida Council for Community Mental Health 2017 Behavioral Health Conference.

The workshop explored:

  • Common problems with behavioral health regulatory compliance, including documentation, billing and coding, treatment plans, and medical necessity.
  • Questions providers should ask to determine appropriate patient settings, as well as third-party payer reimbursement.
  • The importance of physicians incorporating ancillary staff notes and findings within their records.
  • Key words that third-party payers look for to support patient stability and need for discharge.
  • Recommendations for ongoing utilization review plans and payer communication.
  • Ways to define and document what is potentially harmful to an individual or others.

View the presentation below.

Lori additionally presented “How to Avoid Being a Target in the Mental Health Outpatient World.”  View the presentation below.

If you would like more information about medical necessity within inpatient settings, or would like to request a speaker on this topic for your organization or event, contact a PYA executive below at (800) 270-9629.


Denise Hall-Gaulin

Denise Hall-Gaulin

Principal

Lori Baker

Lori Baker

Manager

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