Hospital manual.

  • United States. Social Security Administration.
Date:
1967]
Catalogue details

Licence: Public Domain Mark

Credit: Hospital manual. Source: Wellcome Collection.

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    Item 17. Statement of Services.—Where charges not listed on the form are applied to one of the departments listed, all bills submitted should apply the same charges consistently to the same depart- ments. Describes in greater detail the procedure for submitting the hospital’s own billing form in lieu of the detailed completion of Statement of Services. Includes instructions for showing discounted charges. Explains that noncovered charges should be shown in the Noncovered Charges column except where the noncovered charge is billed routinely to medicare and nonmedicare patients alike, e.g., pathologists’ services included in all billings of laboratory charges. Noncovered charges cannot be applied to the deductible, even where noncovered charges are routinely billed to all patients and included in the Total Charges column. Items A-E. Accommodations.—Accommodation days are always shown as whole rather than fractional days; gives the rules for showing late discharge charges on the billing form. Instruc- tions are included for handling ancillary charges for day of discharge or death and where the patient is discharged on the first day of entitlement. Where there was more than one rate for a given type of accommodation, one of the unused accommodation lines may be relettered and used to show the entry. Item 17A, One bed.—If the patient was in a one-bed accommodation for other than medical reasons, program payment cannot be made for more than semiprivate accommodations, and the patient may not be charged the difference unless he requested such accommodation. The entries to be made in the Total and Noncovered Charges columns are described. Items 17D and E. Intensive care and self-care.—Explains billing entries where the patient is in the intensive care unit for part of a day. Item F. Whole blood.—The explanation for the entries for Pints Furnished, Not Replaced, Charge per Pint, and Total and Noncovered Charges has been revised and expanded to take account of the expanded statement in § 222, particularly as regards blood obtained from independ- ent blood banks. G—O. General.—Explains how items and services which are more expensive or in excess of the services covered by the program, should be shown in the Total Charges and Noncovered Charges columns. Where the patient did not request such services, only the covered charges should be shown in the Total Charges column, and no entry made in the Noncovered Charges column. Where the patient requested such services and the hospital will bill him for them, the Total Charges column will reflect the full charge and the Noncovered Charges column will show the excess charge billed to the patient. P. Inpatient deductible.—This line should show total charges in line “O” minus any physician’s charges included in total charges. R. Coinsurance.—In addition to the total deduction for coinsurance, the rate and the number of days should be shown. The coinsurance rate is $10 or the daily charge, whichever is less. Item 18. Statement Covers Period.—This item should show inclusive dates whether or not all days are covered, except that days before the patient’s entitlement will not be shown. An example shows how this item is completed where the hospital bills periodically for a continuous stay. Item 19, Total Days.—Explains what days should not be included in this item, i.e., benefits exhausted and guarantee of payment does not apply; workmen’s compensation payment is made or can be expected to be made; a National Institutes of Health grant will pay; services are not covered; days on which the patient was on a leave of absence or is away from the hospital because of repeated admissions and discharges; the day of discharge or death. An explanation of noncovered days is required in the Computation of Interim Payment block. Indicates entries to be made where an individual is admitted as an inpatient and is discharged or transferred to another hospital before midnight of the day of admission. Item 21. Date Benefits Exhausted.—This item should not be completed unless benefits are exhausted before date of discharge or death, and during period covered by Item 18. A projected date should not be used.