NY0377 · 60F

Ortho · Psych · Schizophrenia spectrum and other psychotic disorders
Worklist
NY0377 Elevated
60F · Psych
Schizophrenia spectrum and other psychotic disorders
Ortho · from ED · Medicaid
LOS vs expected (GMLOS)
-1.0d
day 8 · GMLOS 9.0d · predicted d10
Barrier families
AU Authorization
Prediction
Day 8–10
Medium confidence
risk 0.373 · 2d remaining
Why this window
No strong drivers in administrative data.
Patient-flow timelineadmission → resolution → window
  • Day 0
    Admission
    ED → Psych, Ortho. Dx: Schizophrenia spectrum and other psychotic disorders. From ED.
  • Day 0
    Prediction
    Elevated excess-LOS risk · risk 0.373 · conf 0.754. Drivers: none.
  • Day 0
    Barriers detected
    Insurance prior-auth (p=0.6, ETA 2.0d)
  • Due Day 2
    Action routed → Utilization-Review Nurse
    Insurance prior-auth: Open prior-auth; submit clinical docs to payer; track determination. [Open]
  • Day 8–10
    Projected discharge window
    Operational estimate (synthetic). Not a clinical claim.
Route actions0/1 closed
Insurance prior-authOpen
→ Utilization-Review Nurse · due d2
De-identified NY SPARCS · admin-baseline model · not a clinical claim · calibration gap disclosed · fairness gate →