Wiki newborn discharge

[GoLeun22]

Hi All,

Our office has always billed insurance under child name/DOB for newborn discharge. I was just informed yesterday by a major insurance company that we should be billing the newborn discharge under the mother name/DOB.

What do you do in your office? Why?

Thanks,
Lisa

 

[ljhaley@gmail.com]

We enter babies in the system under mom's maiden name ex: Smith, Female/Male, DOB with full demographics. Once mom chooses a final name, we update the chart, HOLDING the charges until we confirm via insurance online/phone that the child IS enrolled (verify baby's id#!) on insurance. THEN we send our claim. Eliminates denials for name, enrollment, etc. Most insurances require baby enrollment within 30 days, so your safe from timely filing denials. Only time we submit baby under Mom name/dob is if baby has NO insurance and claims are to be paid under the NYS newborn mandate covering first 3 days of life. Phew! Hope that helps! Good luck

 

[debinvabeach]

Insurance perspective

I work for a regional insurance company in Virginia - we pay for the newborn baby's confinment related expenses whether they add the newborn or not. So billing under the Mother works for us.

My guess is that it depends on the rules of each insurer.

 

[GoLeun22]

Only time we submit baby under Mom name/dob is if baby has NO insurance and claims are to be paid under the NYS newborn mandate covering first 3 days of life.

Is NYS Mandate state specific? I am billing for provider in GA.

The commerical insurances tell the office that child is covered for first 30 days of life under mother, but then tell us when we bill that child is only covered after being added to plan. After being told by one commercial insurance to bill using mom's info, I am curious if they should all be billed that way.