We frequently end up caring for people who are ready to be discharged from an acute care setting (hospital) but are not ready to be going home due to


a. social reasons

b. insurance reasons



How do we bill for these services?



For example,



An unfunded person ends up in End Stage Renal Disease. It takes about 2 months or more for Medicare to kick in. However due to lack of funding till then she cannot access any outpatient Hemodialysis units to consider discharging from the hospital. How do we bill for these days?



Specifically

a. how do we bill for days during which the person needs Hemodialysis (under usual circumstances this would be an outpatient event)? They would still be requiring oral medications almost always and parenteral route medications some of the times.



b. how do we bill for days during which the person does not need Hemodialysis (under usual circumstances this would be outpatient home or care facility living)? They would still be requiring oral medications almost always and parenteral route medications some of the times.



Please advise.





Thanks!