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Inpatient & Annual Deductible billing

  1. Default Inpatient & Annual Deductible billing
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    Inpatient billers, PLEASE HELP!?!?!
    Does inpatient billing depend on DOE (date of entry) or DOS?
    For example, if a patient enters the hospital this year (say 12/28/11) and is discharged next year (say on 1/3/12) will they have to pay the 2012 dedectible for a plan year that begins on 1/1/12? $4500 is at stake here, so please help. Many thanks.

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    Quote Originally Posted by multispec View Post
    Inpatient billers, PLEASE HELP!?!?!
    Does inpatient billing depend on DOE (date of entry) or DOS?
    For example, if a patient enters the hospital this year (say 12/28/11) and is discharged next year (say on 1/3/12) will they have to pay the 2012 dedectible for a plan year that begins on 1/1/12? $4500 is at stake here, so please help. Many thanks.
    That is a question best answered by the insurance payer. Each plan may have different rules for how they apply the deductible when it comes to inpatient hospital stays that lap over from one year to the next. Call the insurance carrier.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. Default Aetna info
    Thanks Arlene. For anyone that is following this or has a question in the future, I DID contact Aetna and their policy is that if the inpt stay overlaps to a new benefit year, a new deductible DOES APPLY! Something to keep in mind both professionally and personally.

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