Two-Midnight Rule: Factors Affecting Reimbursement

Decent Essays
The Two-Midnight rule will affect the reimbursement because CMS pays differently for inpatient and outpatient care. This rule impacts the facility and the physicians because they have to ensure that the right documentation matches the care provided, otherwise it will be denied (Harris & Kelly, 2015). After reading the article, I believe that documentation is the key in receiving reimbursement from CMS. That said, Harris and Kelly (2015) have emphasized that “utilizing all avenues available to evaluate and trend proper patient status assignment is vital” (p. 69). The physician has to ensure that he or she addresses the factors or reasons why a patient needs to stay at least two midnights. Staff education regarding the new Two-Midnight rule

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