If a physician has ordered surgery for a patient, a managed care organization (MCO) case manager may disallow an inpatient stay if the MCO guidelines designate the procedure as best suited for outpatient care.

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Managed care organizations (MCOs) have guidelines for determining whether a procedure should be done as an inpatient or outpatient. If the MCO deems that the procedure is best suited for outpatient care, the case manager may disallow an inpatient stay. This decision may override the physician's order.

If a Physician Has Ordered Surgery for a Patient, a Managed