Medical Necessity/Two-Midnight Rule Reviews
CBIZ combines its clinical expertise with data analytics to provide a targeted review of medical necessity and the application of the Two-Midnight Rule.
All organizations perform medical necessity reviews. However, at CBIZ we have a better way. Our targeted approach identifies those cases that are at the greatest risk for denial and recoupment. Our service provides a focused review and concrete action steps that identify opportunities for performance improvement.
CBIZ’s proprietary data analytics result in the identification of claims that may have been assigned an incorrect patient status. The clinical expertise of our nurse reviewers is then applied to assess those cases at risk. This melding of data analytics, revenue cycle optimization and clinical best practices has created a unique service that helps hospitals and health systems reduce risk and regulatory compliance issues.
This service improves the application of admission processes, increasing the accuracy of level of care assignment, which results in regulatory compliance and optimized revenue.