We have Physicians who see Inpatients at the hospital. They do not always know if the patient is in inpatient or observation status.
When we get the encounter the Physician gives us the appropriate inpatient level of service, when we check the hospital system prior to billing out the claim, they may have changed the status to Observation.
How do you handle these circumstances? In order to be paid we have to bill with the correct place of service and code appropriately?
Can we change the code accordingly? or does the encounter go back to the Physician for a new code based on observation versus inpatient status?
Currently we are changing the code to the appropriate level according the inpatient/observation status.
Just need some guidance...
Thanks!
When we get the encounter the Physician gives us the appropriate inpatient level of service, when we check the hospital system prior to billing out the claim, they may have changed the status to Observation.
How do you handle these circumstances? In order to be paid we have to bill with the correct place of service and code appropriately?
Can we change the code accordingly? or does the encounter go back to the Physician for a new code based on observation versus inpatient status?
Currently we are changing the code to the appropriate level according the inpatient/observation status.
Just need some guidance...
Thanks!