Remember to review the policy!
It has been brought to our attention that many member hospitals can benefit from this Medicare reminder, so our team of experts requested the following be shared: one-day stays with both Medicare and Managed Care claims are appearing frequently. Medicare policy is that for a patient to be considered inpatient, then the stay should exceed two midnights. There are few exceptions to this rule. Death and inpatient claims, where a procedure is performed that is on the inpatient only list, being two. Other than that, very few one-day stays will be paid by Medicare or Medicare Managed Care. So remember, as it has been explained before, “To be a one-day stay the patient would have to be admitted and the hospital administered a treatment that created a miracle; that within 24-hours the patient condition improved enough to go home.” Please use this example as a simple reminder.