Good morning all!
I work for a general surgery practice and recently, because of the lovely RAC's, we have been having issues with one of our hospitals and the Inpatient Vs. Observation status. My coworker (also a CPC) and I have always billed for a patient that is in the hospital more than 24 hours as Inpatient (regardless of how the surgery was originally planned)... Recently, because the RAC's are denying the hospital's Inpatient claims as "not medically necessary", if the surgery was originally planned to be observation, the hospital will bill as such. When their claim gets denied, they instruct the patient to call us and have us "change our coding". Has anyone else been having this issue? If so, what can be done to remedy the situation?
Thanks!
Erin Toavs, CPC
I work for a general surgery practice and recently, because of the lovely RAC's, we have been having issues with one of our hospitals and the Inpatient Vs. Observation status. My coworker (also a CPC) and I have always billed for a patient that is in the hospital more than 24 hours as Inpatient (regardless of how the surgery was originally planned)... Recently, because the RAC's are denying the hospital's Inpatient claims as "not medically necessary", if the surgery was originally planned to be observation, the hospital will bill as such. When their claim gets denied, they instruct the patient to call us and have us "change our coding". Has anyone else been having this issue? If so, what can be done to remedy the situation?
Thanks!
Erin Toavs, CPC