I also wanted to let you know how our policy and procedure is set up, and has been since I started here 7 years ago.

If a pt comes through ER and is made observation, 1 day later meets inpatient criteria we do not go back to the time of ER admit unless it is determined that the patient had met inpatient criteria from the moment he/she came through the ER doors. We place the patient in an inpatient status on the day and time the Dr determines inpatient criteria was met. Its all DRG's and sometimes you come out ahead in the game, sometimes not.

Just a side note-the biggest problem we have with large DRG payments is when we get more than what our bill was and the patient still owes their inpatient deductible. The patient sees the Medicare summary notice and sees that they owe us $840.00 when our bill was $8000.00 and Medicare paid us $9,500.00!! That is the hardest part of my job - explaining why any payer pays the way they do. :rolleyes .

Thanks,

Amy