Four groups of questions to ask about every referral.
Check payer and authorization, skilled need and documentation, medication, and facility capability for each referral. AdmitScore™ lists the open questions under each, with the quote and page they came from, so staff can verify them against the packet before accepting.
Questions to ask under each group
Each group is a set of questions that staff verify against the source packet. Asking the same questions of every referral keeps the review consistent.
Payer and authorization
- Is the plan and authorization readiness clear?
- Are initial days covered?
- Is the facility in network for this referral?
Skilled need and documentation
- Does the documentation support skilled need?
- Does it support the therapy intensity and the wound or nursing requirements?
- Are there missing pages?
- Are any orders unclear?
Medication
- Are there high-cost medications to clarify before the facility commits a bed?
Facility capability
- Does the referral fit the facility's capabilities?
AdmitScore does not decide, approve, or guarantee anything. For the full list of what to confirm in a packet, use the documentation checklist.
Also see: hospital-to-SNF referral triage, faster SNF admissions decisions, and How a review works.