Wiki Inpatient hospital stay and provider charges

[bradleybfam3]

Patient was seen in hospital for a procedure requiring an epidural non-OB related. I am billing for the physicans time for the date of service. This hospital claim is paying but mine is denying for benefit time period reached. I have been looking for a modifier to append to distingish the services from one another but I can't find the appropriate one. I'm hoping someone else has run into this?

 

[thomas7331]

There's no modifier to distinguish a physician's claim from a hospital claim, but it's not clear to me that this is what the problem is. 'Benefit time period reached' suggests to me that perhaps the patient's benefits have been exhausted and there's no additional coverage available, in which case you may need to bill the patient. If it were me, I would contact the payer and get clarification on reason for the denial before trying to determine what course of action is needed next.