Wiki Newborn Hospital billing

[joyjankowski]

Hello,

I'm looking for some information on who the baby's bills after delivery are billed under. Is it a payer decision to have them billed out under the mom or the baby's name? Do the bills for the baby start as soon as the baby is born?

Thank you,

 

[coder80]

I bill under the baby's name with the mom ID. Currently only Mediciad requires baby name and baby is when billing

 

[plpz]

Hi joyjankowski,

For Commercial Plans:

I work as an A/R & Payment Specialist for a group of Neonatologist and often in contact with the hospital billing office regarding payments and eligibility. Most commercial payers don't have specific rules when it comes to billing newborn unlike Medi-Cal/Medicaid. It really depends if the parents added the baby to their plan or not. If parents did, then you can bill it under the newborn's name but if not, you have to bill under mom's name. My biller adds "BG or BB" = "Baby Girl or Baby Boy" after mom's name (Eg. MariaBG (Last Name)). This usually works and they will pay if the mom's plan is not a self-insured plan (self-insured plan will require for newborn to be added before it will cover any services regardless if the benefit states "Newborn is covered 1st 30 days".

Hope this helps.

Peter Lopez, CPC