Smart decisions. Lasting value.

Let Crowe Horwath LLP help you decide if CMS’ hospital appeals settlement is right for your hospital. Already know it isn’t? We’ve got programs to help your organization navigate the “two-midnight rule” in order to maximize revenue from observation-status patients.

RAC Appeal Assessment*
  • Assess each claim against established criteria, using clinical coding and physician advisement
  • Determine probability of appeal success for each claim
  • Aggregate findings and provide recommendation regarding 68% offer
*Must be completed by Oct. 31, 2014
Observation Services Program Benchmarking
  • Compare current observation vs. inpatient rates against national market and peer group (for example, bed size)
  • Determine estimated financial impact of inpatient to observation transition (by diagnosis)
  • Assess top 20 functional requirements of a better-performing observation program
Observation Services Program Assessment
  • All of Observation Services program benchmarking (listed adjacent)
  • Assessment of functional (key responsibilities), structural (staffing model), technical (use of aides, prompts, criteria) and patient flow
  • Recommendations regarding precision inpatient status determination and necessary program improvements

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Brian B. Sanderson
Managing Principal, Healthcare Services