Wiki OB hospital charges for Medicaid pt- help please!

[mesimpson0831]

Hi! I work at an office that has 3 different physicians who deliver babies. I'm not sure how to bill for Medicaid patients (non-global) in these instances:

12/10/17- Dr. A admits patient who is in labor
12/11/17- Dr. A does hospital visit on pt who is still in labor- (I've been told not to charge and I've also been told to charge for antepartum.)
12/13/17- Dr. B (in same practice as Dr. A) performs a C-section on pt
12/14/17- Dr. A does hospital visit
12/15/17- Dr. A does hospital visit
12/16/17- Dr. A does discharge-- (I've read conflicting info regarding this being included in delivery)

Okay- so it's my understanding that the H&P is included in the delivery. What about the other visits and the discharge? And keep in mind these are 2 different docs but part of the same group practice.

Thanks so much!
Megan Simpson

 

[cgaston]

If they're billing under the same tax id# they are for all intents and purposes the same provider. So look at it as if one doctor provided all of these services.

 

[ddavis024]

OB hospital charges for Medicaid pt

First, you bill these as one provider if they are all part of the same group. Check your Medicaid carrier regulations. I work with 2 different states and they have certain rules. Generally, with the admit in labor and the rest of that hospital stay is part of the delivery. The example you provided would be global care unless her insurance changed during the pregnancy.

I hope that helps.

 

[mesimpson0831]

Thanks for replying! In our office, we are told for Medicaid to bill each visit separately. We bill individual OB office visits individually and I've always billed delivery only but it's never been clear what all is included with the delivery only and if I bill any of the other parts of the hospital stay separately or not. I've been told different things.