Harbor:Interqual Override Notes

Interqual Override Notes

  • Background
    • Secondary review of case by attending/fellow not caring directly for patient
    • Each denied day loses hospital ~$5000/day
    • May get denied still because doing obs/short stay and CORE upstairs, and not having surgical obs upstairs
  • Note:
    • Be specific about need for inpatient admission, diagnosis, illness severity, complexity
    • "Patient needs admission for_"
    • Try not to use the words "monitoring, observation, work up" which get denied
  • Common examples:
    • Acute CHF exacerbation requiring IV diuresis
    • Cellulitis, pyelonephritis, pneumonia requiring IV antibiotics, failed outpatient antibiotics, hardware infection, immune compromised
    • Acute cholecystiis, appendicitis requiring IV antibiotics and inpatient surgical management
    • NSTEMI requiring anticoagulation, urgent cardiac cath
    • Hypotension requiring IVF, pressors