Kaidachi
Contributor
The facility I code for had a patient that came in through the ED and was admitted to Observation 4/20/25. After UR submitted a request for inpatient approval it came through but the transfer to inpatient was done on 4/22/25 (reason for the transfer) - 'PT MEETS INPT CRITERIA' Pt discharged 4/23/25.
The approval came through for the entirety of the stay (4/20-23).. Is the facility able to bill the entire visit as INPATIENT or the one day that they were considered inpatient due to transfer order.
If they can bill the entire stay inpatient, should the original observation order be amended to indicate should be inpatient? This was my initial thought on the matter.
I honestly don't like them changing level of care based on what an insurance would pay. I feel it should be based on what the provider deems is necessary for their care.
The approval came through for the entirety of the stay (4/20-23).. Is the facility able to bill the entire visit as INPATIENT or the one day that they were considered inpatient due to transfer order.
If they can bill the entire stay inpatient, should the original observation order be amended to indicate should be inpatient? This was my initial thought on the matter.
I honestly don't like them changing level of care based on what an insurance would pay. I feel it should be based on what the provider deems is necessary for their care.