AdmissionCare is a core solution within EvidenceCare's BetterCare Platform, specifically designed to address one of the largest drivers of lost hospital revenue: inpatient bed status denials due to inadequate medical necessity documentation. The software is an EHR-integrated Clinical Documentation Integrity (CDI) tool that places evidence-based guidance directly into the physician's workflow at the point of care.
Key Capabilities and Benefits
AdmissionCare empowers emergency physicians and hospitalists to make accurate bed status determinations (Inpatient vs. Observation) by providing real-time access to clinical and payer criteria, including content from industry standards like MCG and InterQual. This proactive approach ensures that the required medical necessity documentation is captured upfront, eliminating documentation gaps and reducing the risk of claim denials. This process streamlines the entire patient admission workflow, accelerates handoffs between the Emergency Department and inpatient teams, and significantly minimizes interruptions to clinicians from Utilization Review (UR) and physician advisors.
Target Users and Use Cases
- Target Users: Emergency Physicians, Hospitalists, Utilization Review (UR) Teams, Revenue Cycle Departments, Clinical Documentation Improvement (CDI) Specialists.
- Primary Use Cases: Hospital Admission Management, Medical Necessity Documentation Compliance, Proactive Denial Prevention, Revenue Cycle Optimization, and Clinical Workflow Improvement.
Financial Impact
Health systems utilizing AdmissionCare have reported significant financial returns, including millions in additional reimbursement, reduced denial rates, and an overall 5-10x ROI for the platform by aligning clinical and financial goals.
