QUESTION 45 OF 55
How would you handle a problem in which Utilization Review wants you to discharge a patient who you feel isn’t medically ready for discharge?
This pits you against the hospital to come up with a solution for everyone's benefit. UR actions are usually based on dollar issues, protecting the hospital bottom line from insurance denials.
"If I felt it would be dangerous to send a patient home, I would write a note of necessity for continued admission, on medical grounds, so that UR could submit it for approval from a third-party payer and document the case for Risk Management. If the patient just wanted to stay out of convenience, I would explain that he or she has satisfied criteria for discharge, but I would also offer home health follow-up if the patient or family desired and it were allowed/authorized."
