Identify a planned admission
Smart Claims Engine for Healthcare executes the logic for identifying planned admissions that fall into the General Population category from the CE_IsPlannedAdmission collection, which uses decision tables, when rules, and a data transform to drive the end-to-end process illustrated below.
The following data tables (identified below with sample codes) are used to support this process.
- Readmission planned procedure table
- Readmission planned diagnosis table
- Readmission potentially planned procedures table
- Readmission acute diagnosis table
For claims that have been identified as planned admissions, according to the end-to-end planned admission review process, Smart Claims Engine for Healthcare displays a note in the claims history indicating the result of the review.
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