The authors integrated into an existing hospital information system a preadmission screening system, intended to reduce payment denials and reimbursement shortfalls that result from improperly classifying the billing status of patients. They report the results of efforts to validate the expert system upon which the preadmission screening system is based.
ShahodaT.Preadmission review cuts hospital use. Hospitals. August 1984; 54–55.
2.
ImperialeT.F.SiegalA.P.CredeW.B.KamensEA. Preadmission screening of Medicare, patients, the clinical impact of reimbursement disapproval. JAMA.1988; 259: 3418–21.
3.
MartinJB. Admissions screening and control, the front end of effective utilization management. In: Proceedings of the Forum on Productivity Improvements in Utilization Management.Chicago, American Hosptial Association, 1989; 77–86.
4.
PryorT.A.GardnerR.M.ClaytonP.D.WarnerHR. The HELP system. Med Systems.1983; 7(2): 87–102.
5.
Review Criteria. 3M Company, 1989; 1–3.
6.
RestucciaJ.D.PayneS.M.C.LenhartG.ConstantineH.P.FultonJP. Assessing the appropriateness of hospital utilization to improve efficiency and competitive position. Health Care Manage Rev.1987; 12(3): 17–27.
7.
Codefinder products interface software for the IBM/PC/XT/AT, user manual. 3M Company, 1988; 15–28.
8.
VladeckBC. Medicare hospital payment by diagnosis-related groups. Ann Intem Med.1984; 100: 576–91.
9.
IezzoniL.I.MoskowitzMA. Clinical overlap among diagnosis-related groups. JAMA.1986; 255: 327–9.
10.
FleissJL. Statistical methods for rates and proportions.New York: John Wiley & Sons, 1981; 218.
11.
LloydS.S.RissingJP. Physician and coding errors in patient records. JAMA.1985; 54: 1330–6.
