Screen Medicare referrals for SNF qualification, profile patient risk, and predict denial reasons — in under 60 seconds.
Patient has only 2 qualifying inpatient day(s), which does NOT meet the Medicare 3-day minimum requirement.
Patient was initially placed under observation before being converted to inpatient.
Documented history of aggressive behavior
Patient requires one-to-one supervision
Patient spent ~47 hours under observation before conversion to inpatient status.
Drag-and-drop physician orders, face sheets, ED notes, progress notes, H&P, and discharge summaries. Scanned PDFs work too.
Upload the patient's clinical documents to screen for Medicare SNF qualification.
Documents are classified, cross-referenced, and analyzed for 3-Day Rule qualification, behavioral risk, and benefit eligibility.
Patient placed under OBSERVATION for monitoring.
ADMISSION ORDERS - OBSERVATION STATUS: Place patient under OBSERVATION.
Hospital day 2. Observation status.
CONVERT TO INPATIENT STATUS. Patient clinically deteriorating.
Hospital day 4 (IP Day 2). Continued IV antibiotics.
Discharge to SNF for continued skilled nursing care.
Get a qualification verdict, day-by-day timeline, risk flags, denial predictions, and patient risk profile.
Referral documents bury behavioral concerns in clinical euphemisms. MedScreen decodes them — surfacing aggression, elopement risk, psychiatric history, substance use, and supervision needs before you make an admission decision.
"Patient became confused and agitated overnight. Attempting to remove O2 cannula repeatedly. Pulled out peripheral IV at 02:30, requiring IV restart."
"Soft wrist restraints applied per physician order after de-escalation attempts failed (patient kept removing O2, desatting to 86%)."
"1:1 sitter called."
"Alert, oriented x2 (person, place). Intermittently confused overnight. Reoriented with cues."
9 specific Medicare denial reasons — ranked by likelihood with prevention actions and CMS regulatory citations.
Fewer than 3 qualifying inpatient days
Face sheet and clinical docs disagree on status
Admitted after 10 PM — auditor red flag
No explicit inpatient admission order found
All 100 SNF benefit days used in this period
Medicare Advantage plan requires prior auth
Inconsistencies between documents
Exactly 3 days with multiple risk flags
Another payer should be billed first
Each denial reason includes specific prevention actions and CMS regulatory citations (e.g., 42 CFR § 409.30).
Automatically detects plan type (Original Medicare vs. MA), checks remaining SNF benefit days, and catches Medicare Secondary Payer situations that cause automatic denials.
Auto-generates professional messages for referring hospitals, pre-populated with case-specific questions about observation timing, status discrepancies, and behavioral concerns.
Field-level encryption on all patient data, immutable audit trail, role-based access control, and auto session timeout. Hosted on Google Cloud with a signed BAA.
Request a demo and screen your first referral in under 60 seconds.