This patient with past medical history of diabetes, hypertension, asthma and obesity presented with dizziness and chest pain. Patient had a history of a "heart problem" in the past but was unable to clarify what this was. The patient was slightly hypertensive in the ER, remainder of exam was normal. The health plan's determination is upheld.
The patient was treated with IV fluids, repeat labs and monitoring. While the patient was appropriate for monitoring, based on the patient's hemodynamic stability and lack of ischemic changes, this could have been accomplished at a lower level of care status and did not require an inpatient level of care.