Unit Training Topics

Topics Observation vs. Inpatient admit types Room Rate Accommodation Codes Using the Meditech “IN TRANSFER” function NUR ADT and ADM order entry Discharging patients Preparing Charts for the Medical Records Dept

Observation Admissions Observation admissions will appear as an ADM INo status in Meditech The ONLY acceptable observation admission Room Rate Accommodation Code is 23HR. (All other accommodation codes are for inpatient accounts only.) The 23HR Room Rate Accommodation Code allows the observation account to generate the appropriate “Hourly” observation charges. Patients may possibly remain as observation beyond a 23-hour time period.

Hourly Observation Charges Hourly “23HR” room rate accommodation code on account with MED service Please note - Charges may not be current.

Inpatient Admissions Inpatient admissions will appear as an ADM IN status in Meditech The 23HR Room Rate Accommodation code should NOT be placed on an inpatient account. The Inpatient Room Rate Accommodation Code drives the “Daily” bed charge that Meditech applies to the account.

Daily Inpatient Bed charges Based on the Room Rate Accommodation Code Daily “MED SUR” room rate accommodation on account (Unit 35) Please note - Charges may not be current.

ADM IN (Inpatient) Accommodation Codes IC Intensive/ Critical Care INTERM Intermediate/ SIMCA MEDSUR Medical/ Surgical MPSYCH Med Psych OB Obstetrics PC Telemetry PED Pediatric Care (0-13 yrs) NBN Newborn NIC2 NICU Level 2 NIC3 NICU Level 3 NIC4 NICU Level 4 SNF Skilled Nursing Facility (Unit 54 admissions only)

IN (Inpatient) Accommodation Codes Typically a particular inpatient accommodation code is associated with a unit, though other accommodation codes may be appropriate. Refer to the patient’s orders. (e.g.: Unit 36 is a MPSYCH unit, but may house MEDSUR patients as well.)

Transferring Patients What to look for… Please note the admission type when transferring a patient (ADM IN vs. ADM INo) If the patient’s admission status should be changed, DO NOT change the Room Rate Accommodation Code. Enter the admission order into Meditech to request the change. Change the PRE SUR service to SUR when transferring patients from a PACU to a unit. Additional INFO to NOTE – Unit 54 (Skilled Nursing Facility/ Sub acute) accounts should NOT be transferred “to” or “from” another hospital unit. *Unit 54 admissions MUST be processed using a separate visit number/ account for billing purposes. *Patients MUST be discharged and readmitted. *Unit 54 will call Patient Access for readmission.

Transferring Patients using the IN TRANSFER MEDITECH function ADM INo (Observation) accounts must have the 23HR Room Rate Accommodation code DO NOT change the Room Rate Accommodation code to reflect a status change. Enter the appropriate order request (NUR ADT or ADM) and the admission type and accommodation code will be changed by Patient Access. Change the PRE SUR service to SUR when transferring a patient from the PACU to a unit.

Admission and Account Status Change Order Requests All admission order requests must be entered through Meditech (NURADT order) Enter all admission status change requests in Meditech (ADM order) ADM - Observation to Inpatient ADM - Inpatient to Observation DO NOT change the Room Rate Accommodation Code prior to entering the order request. Patient Access will change the Room Rate Accommodation Code when processing the order request.

All admitting orders require a patient status order for inpatient or observation. If clarification is needed for a patient’s admission order, please affix a Patient Status Clarification Order sticker onto a Physician’s Order Sheet to be completed by the Attending physician.

Initial admit (NUR ADT) order entered via Order Entry

Admission status change (ADM) order entered via Order Entry

Orders entered via ORDER ENTRY will appear in EMR and will generate a printed request to Patient Access EMR - ORDER ENTRY

Discharging Patients Please discharge the patients in Meditech for the actual time that the patient was discharged, per the patient’s medical record. The unit patient census should be confirmed and verified on a nightly basis prior to faxing a copy of the census to Main Patient Access.

Preparing Charts for the Medical Records Department Please DO NOT remove or discard any pages from the patient’s medical record ALL pages of any multi-part signature forms must remain with the chart to be scanned by our Medical Records (Optical) Department

Preparing Charts for the Medical Records Department An Important Message from Medicare About Your Rights form is a 2-page form. The Permissions Acknowledgements form is a 4-page form. ALL pages MUST remain in the patient’s chart.

Summary Please enter the appropriate Room Rate Accommodation Code based on the admission type and patient’s orders Change the service from PRE SUR to SUR for INo surgical accounts transferred from the OR recovery areas Enter ALL admission and status change request orders through MEDITECH via ORDER ENTRY Enter the documented discharge date and time into Meditech DO NOT remove or discard any pages from the patient’s chart

Questions If you have any questions, please contact a Patient Access Applications Trainer at x3086 or x6543 Email the MT Registration Issues GroupWise mailbox with any Meditech patient account related problems. For Medical Records related questions please call the Medical Documentation Supervisor x2557