[MEDITECH-L] Question about Proration Holds

[Dunn, Elaine]

Hello,



I am looking for a way to prevent observation charges from dropping on
inpatient status bills in BAR in an attempt to correct charging errors
entered in other modules. I have been told that a proration hold may
accomplish this. Has anyone used a proration hold for this purpose?
Or, is there another way to accomplish this? Any input would be greatly
appreciated.



Thank you,



Elaine Dunn, MS, RRT, RPSGT

CDM Analyst

Adena Health System

272 Hospital Road

Chillicothe, Ohio 45640

ed...@adena.org <mailto:ed...@adena.org>

740-779-4281






******************************************************************

This email and any files transmitted with it are proprietary and confidential
and intended solely for the use of the individual or entity to whom they are
addressed. If you have received this email in error please notify the system
manager at ab...@adena.org. Please note that any views or opinions presented
in this email are solely those of the author and do not necessarily represent
those of the company. No employee or agent is authorized to conclude any binding
agreement on behalf of Adena Health System with another party by email without
express written confirmation from Adena Health System authorized individuals.

Finally, the recipient should check this email and any attachments for the presence of viruses.
The company accepts no liability for any damage caused by any virus transmitted by this email.

Adena Health System, 272 Hospital Road, Chillicothe, Ohio, USA,http://www.adena.org

******************************************************************

[Purvins, James A.]

Elaine,
Claim Checks and Proration Hold may or may not be hospital specific.

Looking at Magic 5.5 - there is a claim check CHG CAT 'LIST.

>From the documentation, this hold may be what you are looking for.

Some claim checks cannot be used as proration holds but this check does
not have any disclaimers of that sort.

So you would attach the observation charge category (usually 762 or
maybe 761) to CHG CAT 'LIST to your inpatient proration rule and this
should stop any inpatients with Observation charges.

You may also need to copy the <standard> claim check / proration hold to
a zCHG CAT 'LIST and add the revenue code.

That is about all the specifics I can think of. Your Meditech Billing
Specialist should be able to tie any other lose ends that I may be
missing here.

Good Luck,

James Purvins
Inland Northwest Health Services
(509) 232-8384

This e-mail and any attachments are confidential and may also be
privileged. If you are not the named recipient, or have otherwise
received this communication in error, please delete it from your inbox,
notify the sender immediately by replying to the message, and do not
disclose its contents to any other person, use the information for any
purpose or store or copy the information in any medium. Thank you for
your cooperation

[Bodnar-Anderson, Cindy]

Magic B/AR has a claim check to pass Observation patients based on Revenue Code.....
Claim Check OBS & PRORATE Name OBSERV PAT PRORATE NEED 76X

Claim Check Group Required Data Entered N
Prescreen UR Accounts?
Standard Instructions Enable for Online Editor?
This claim check is only for proration. It may not be used on a claim.

This proration hold check will automatically pass all patients, except for
observation patients (ie. patient status = OBSERV). Observation patients
must have at least one charge category in a list.
/////
but it sounds like you are approaching this from the opposite direction.... make sure an Inpt doesn't have a Rev 76X code...
you can build one of these, and contact Meditech to have it associated to either a Rev Code or a list of specific charge codes... so the logic would be
If Inpatient, if account has a <rev code> or <charge code> in a Claim Check Data List then fail.
You wouldn't even need the If Inpatient, as you would only be using this Proration Check for the Inpatient Proration dictionary (unless you combine In and Out in your Proration Rules). Our Observation patients have their own Prorate Rules.

HTH,
Cindy Bodnar-Anderson
Senior Programmer/Analyst
IS, Regional Health
Rapid City SD 57701

Hello,

Thank you,

CDM Analyst

Adena Health System

272 Hospital Road

Chillicothe, Ohio 45640

ed...@adena.org <mailto:ed...@adena.org>

740-779-4281

******************************************************************

******************************************************************

***Note: The information contained in this message, including any attachments, may be privileged, confidential, and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the Sender immediately by a "reply to sender only" message and destroy all electronic or paper copies of the communication, including any attachments.

[Amber Holcombe]

Elaine,

MT Standard CHG CAT LIST should work for this. You define a data list
of Charge Categories, attach the data list to the check, then add the
check in proration.

Amber Holcombe
Applications Analyst, Patient Accounts
Olympic Medical Center
Phone: (360)417-7124 Fax: (360)417-7342
"Excellence is not a skill. It is an attitude." ~ Ralph Marston

-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of Dunn, Elaine
Sent: Thursday, November 08, 2007 5:17 AM
To: medit...@MTUsers.com
Subject: [MEDITECH-L] Question about Proration Holds