I’m designing some late charge reports for my health system and noticed that histology and cytology lab charges are consistently late (posted after the bill hold of 4 days). Many are late due to specimens being grown first. I believe that to be the case with a small number of charges, but I know that other charges (a biopsy done while the patient is still sedated) ought to go immediately. Is there a general consensus whether charges from these departments should be exempt from the four-day threshold?
Answer: We also face this situation at my hospital. You can’t exempt an entire department’s charges from the late charge report if most are processed quickly (e.g., surgery), but a small number have a process that requires more time.
Don’t exempt the department. It will always show up with more late activity than other departments. I recommend keeping an eye on the situation to make sure it is related to specimens that have to be grown. If there is a way to identify cases that have late charges, so you can hold the claim, all the better, but if not, or if it doesn’t affect payment, then there is no issue. These late charge deadlines and reports act as tools for frequent discussions between the revenue folks and the clinical areas.
This question was answered by: Ruth Landé, senior vice president, patient revenues, Memorial Sloan-Kettering Cancer Center, and a member of HFMA’s Metropolitan New York Chapter.
| What do you think? Please share your thoughts on this question in the comments section below. |
The information provided through the Forum’s Ask the Expert service does not constitute legal advice, even when the advice is provided by lawyers. You need to obtain your own legal counsel for legal advice and consider the laws and regulations that govern your state. The content and opinions expressed are those of the Forum experts, and not that of their employers or of HFMA. HFMA does not endorse the material or warrant or guarantee its accuracy. The responses are based only on the specific facts or circumstances provided. Forum experts cannot be held liable for outcomes related to any information provided.
Pose another question to our Revenue Cycle Forum experts.
