Question

yourre an inpatient coder in a hospital. you've just coded a medicare part a record with a diagnosis related group reimbursement of $12000. you notice in the hospitals computer billing system that the patient's charges are $19500. that's $7500 more that the hospital will be reimbursed. how does the difference between the chasrges and the drg reimbursement become resolved

Answer 1

If medicare's DRG is $12000, the hospital can balance bill the sub for the $7500, or the hospital can write off the remainder as paid in full. This is why medicare supplements policies can be important for the elderly.