Hospital Patient Status Changes

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Posts: 2
Joined: Wed Nov 01, 2017 3:18 pm

Wed Oct 31, 2018 6:37 pm

If a patient's hospital stay has a status change after the patient has already discharged from inpatient to outpatient due to lack of medical necessity and the hospital self-denies their claim to Medicare, does the pro-fee side need to write off their charges as well? We have typically already been paid, do we need to refund if the hospital decides to self-deny? I have researched this and have not come up with any guidance for the pro-fee side of this scenario. Any help or direction you could give would be greatly appreciated!

Thank you in advance!
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