preadmission certification


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preadmission certification

[prē′ədmish′ən]
a system whereby physicians are required to obtain advance approval for nonemergency admission of Medicare, Medicaid, and managed care patients to hospitals, as well as most third-party payers. The system is intended to determine whether the patient can be treated as an outpatient or in another, less expensive manner than hospitalization. Emergency admissions require post hoc approval. Also called precertification.

preadmission certification

Authorization granted to the patient for hospital admission after a review of the patient's proposed need for inpatient services. In some settings, if certain set criteria are not met, then the admission is not allowed.
See also: certification
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References in periodicals archive ?
States rate preadmission testing, preadmission certification, and lock-in as the most effective cost-containment methods.
A majority of employees in 1987 were covered by a mandatory surgical second opinion program, and 45 percent were covered by preadmission certification review.
For example, most psychiatric hospital admissions are emergencies, making it difficult to have an effective preadmission certification program.