Table of Contents

Table of Contents

Physician Advisor Handbook

  • Page 3      Disclaimer
  • Page 4      Clinical Revenue Cycle Components and Process Overview
  • Page 5      Importance of UR and Who Can Admit a Patient
  • Page 6      Medicare Conditions of Participation (CoP)
  • Page 9      Medicare Benefit Policy Manual – Chapter 1 Inpatient
  • Page 10     Medicare Benefit Policy Manual – Chapter 6 Outpatient
  • Page 12     Difference between IP and OP (OBS)
  • Page 15     Effects on the hospital, the beneficiary, and the physicians
  • Page 17     Discussion and practice on how to review cases:
  • Page 18     What is the Inpatient Prospective Payment System (IPPS)
  • Page 18     What is the Outpatient Prospective Payment System(OPPS)
  • Page 19     Inpatient Only List
  • Page 22     The Two-Midnight Rule
  • Page 26     Condition Code 44, Condition Code W2, Occurrence Code Span 72
  • Page 31     Length of Stay (LOS) Management
  • Page 34     Summary and Contact Information


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