Method of assuring that only those patients who need hospital care are admitted. Certification can be granted before admission (preadmission) or shortly after (concurrent). Length of stay for the patient’s diagnosed problem is usually assigned on admission under a certification program.
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Admission date
The month, day, and year the patient is admitted to the hospital as an inpatient or as an outpatient for services or tests. Admission date is inserted in Field 12 of the Uniform Bill (UB-04) inpatient hospital billing claim form. The electronic version requires an eight-character date listing year, month, and day: 20XX0328. For an admission notice for hospice care for a Medicare patient, enter the effective date of election of hospice benefits.
Admission discharge transfer system
Computer software program used by hospitals to keep track of patients from the time of admission to time of discharge or transfer to another facility.
Admission of age
In life insurance the insured may have his policy endorsed ‘age admitted’ by supplying the insurer with his birth certificate. This may occur at inception or during the currency of the policy. When age has been admitted, the insured or his representatives will not to have to prove the insured’s age when a claim is made.
Admission of liability
1. An admission by an insurer or reinsurer that they are liable for a claim under their contract. 2. An admission by an insured that he is liable for injury or damage caused to a third party. In a liability policy the insurer’s conduct of proceedings clause and non-admission of liability clause prevent the insured from negotiating with the claimant or admitting liability without the insurer’s consent. The clauses are conditions precedent to liability.
Admission process
Registration of a patient either as an inpatient or outpatient for receiving medical services in a health care facility. Admissions staff give the patient a registration number and obtain demographic, insurance, and medical information, which is entered into the computer system.
Admission review
Review a patient’s medical case for appropriateness and necessity of admissions.
Admission wire
Blue Cross and Blue Shield phrase; a formal notice sent by a host plan to the home plan that one of their members has been admitted into a plan hospital in the host plan’s area and a request for membership information. See also approval wire.
Admission/1000
The number of hospital admissions for each 1000 members of the health plan.
Admissions per 1000 (APT)
Method used to compare the number of hospital admissions for defined populations for a specific period of time, usually 1 year. APT is commonly used by managed care plans to evaluate utilization management performance. Admissions per 1000 formula: number of hospital admissions for a population divided (÷) by the number of persons in that population, and the result multiplied (×) by 1000.