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Hospitals Hospital Changes and
Corrections Inpatient Hospital Per Diem Rate Schedule (01-01-03) UPDATE: August 1, 2000/September 1, 2000 AMENDED: February 1, 2002 AMENDED: January 1, 2003 Disproportionate Share Hospital (DSH) Services [formerly Kentucky Hospital Care Program (KHCP)] (March 27, 2002: Update December 10, 2002 NEW VENDOR NUMBER (October 16, 2002) Updated Inpatient Hospital Per Diem Rate Schedule (February 1, 2002) Updated Inpatient Hospital Per Diem Rate Schedule(July 23, 2001) HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM RATE Kentucky Hospital Care Program (KHPC) (March 27, 2000)
SERVICE FEE MEMORANDUM MS-CE-02-03-13 RE: HOSPITAL CHANGES AND CORRECTIONS Name Change: 611226399-00
Baptist Hospital
Northeast
$ 741.37 LaGrange, KY 40031 Address Change: 610724492-00
Greenview Regional
Hospital
$ 918.89 Atlanta, GA 30384-2775 Vendor Number Change: Madisonville, KY 42431 Vendor Number Change/Name and Address Correction: 616001218-JQ
University of KY Hospital
$1,208.80 Lock Box 951326 Cleveland, OH 44193
Update Service Fee Memo ORIGINAL DATE: July 1, 2000 UPDATE: August 1, 2000/September 1,
2000AMENDED: February 1, 2002 RE: HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM RATE SCHEDULE AND OUTPATIENTHOSPITAL SERVICES HOSPITALIZATION: AMENDED INPATIENT HOSPITAL PER
DIEM RATE SCHEDULE AND OUTPATIENT This Amended Hospital Per Diem Rate Schedule (01-01-03) is being issued to update inpatient per diemrates for seven (7) hospitals. Corrections are being bolded, italicized and underlined in red print. A hard copy of this SERVICE FEE MEMORANDUM will not be mailed to you. The updated hospital per diems are effective for service dates on or after January 1, 2003.If you have issued any pay documents at old inpatient per diem rates for January service dates, you may adjust to the updated per diems prior to invoicing for payment. I apologize for any inconvenience that this may cause you. It
took longer than anticipated to update this Cover Pages 1 and 2 are not in the Case Management System.
You should therefore maintain a hard copy Pages 3 - 13 contain information pertaining to Inpatient Per
Diem Rates which are in the Case Management
AMENDED UPDATES (3) SERVICE FEE MEMORANDUM ORIGINAL DATE: July 1, 2000 UPDATE: August 1, 2000/September 1, 2000 AMENDED: January 1, 2003
RE: AMENDED HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM
INPATIENT HOSPITALIZATION Coverage at the inpatient per diem rates times the number of
days of hospitalization. Non-allowable charges OUTPATIENT HOSPITALIZATION Outpatient Surgery If Pre-Admissions Tests are performed on date(s) prior to the consumer’s scheduled outpatient surgery date, hospital charges for such tests should be authorized at the established Relative Value Schedule (RVS).
Diagnostic Services Coverage for outpatient diagnostic (evaluation and management, medicine, radiology, and pathology) services will be at Relative Value Schedule rates.
Emergency Room Coverage for emergency room visits will be provided accordingly: Diagnostic Procedures: Relative Value Schedule Rates Emergency Room, Recovery Room, Drugs, and Supplies: By Report
DISPROPORTIONATE SHARE HOSPITAL (DSH) formerly
KENTUCKY HOSPITAL CARE PROGRAM When a consumer eligible for both DSH and DFB/DVR, DSH is the
first payer when funds are available.
VENDOR # NAME AND ADDRESS PER DIEM 610444707-04
Baptist Hospital
East
702.35 610444707-01
Baptist Regional Medical
Center
689.55 Corbin, KY 40701 610624017-00
Berea Hospital,
Inc.
646.74 Berea, KY 40403 610974433-03
Bourbon Community Hospital
484.79 Paris, KY 40361 (Formerly Columbia Hospital Paris) 610432526-00
Caldwell County Hospital,
Inc.
611.30 Princeton, KY 42445 610445826-00
Cardinal Hill Rehabilitation
Hospital
640.17 Lexington, KY 40504 610444815-00
Caritas Medical
Center
819.85 Louisville, KY 40215 (Formerly Sts. Mary and Elizabeth Hospital) 610655598-00
Carroll County Memorial Hospital
1,029.02 Carrollton, KY 41008 610654135-00 Caverna Memorial Hospital 785.05P. O. Box 120 Horse Cave, KY 42749 610444707-00
Central Baptist
Hospital
1,179.63 Lexington, KY 40503
610475632-00
Clark Regional Medical
Center
702.06 Winchester, KY 40391 616008014-01
Clinton County
Hospital
413.85 P. O. Box 387 Albany, KY 42602 610391376-00
Crittenden County
Hospital
658.03 Marion, KY 42064 610492356-00
Ephraim McDowell Regional Medical
Center 713.39 Danville, KY 40422 610461742-00
Flaget Memorial
Hospital
716.43 Bardstown, KY 40004 610598543-00
Fleming County
Hospital
643.02 Flemingsburg, KY 41041 610604320-00
Fort Logan
Hospital
521.10 Stanford, KY 40484 610859329-00 Frankfort Regional Medical Center 719.58Billing Remittance 3304 Briley Park Boulevard South Nashville, TN 37207 (Formerly Columbia Hospital Frankfort) 610675361-00
Franklin-Simpson Memorial
Hospital
522.03 Brookhaven Road Franklin, KY 42134 611029768-08
Frazier Rehabilitation
Center
1,088.47 Louisville, KY 40201 616002384-00
Garrard County Memorial
951.25 Lancaster, KY 40444 610974433-02
Georgetown Community Hospital
860.74 Georgetown, KY 40324 (Formerly Columbia Hospital Georgetown) 610724492-00 Greenview Regional Hospital 918.89P. O. Box 90024 Bowling Green, KY 42101 (Formerly Columbia Greenview Hospital) 611022426-01 Hardin Memorial Hospital 925.00913 North Dixie P. O. Box 2289 Elizabethtown, KY 42701 ATTENTION: PATIENT ACCOUNTS 520795508-08
Harlan Appalachian Regional
Hospital
700.99 Harlan, KY 40831 610420440-00
Harrison Memorial Hospital
731.68 Cynthiana, KY 41031 520795508-16
Hazard Appalachian Regional
Hospital
574.71 631184835-00
Healthsouth Northern KY
Rehab
625.55 Edgewood, KY 41017 (formerly American Health Resources DBA Healthsouth) 251573943-00
HealthSouth Rehab
Hospital
702.35 134 Heartland Drive Elizabethtown, KY 42701 (Formerly Lakeview Rehabilitation Hospital) 610658773-04
Highlands Regional Medical
Center
773.49 P. O. Box 668 Prestonsburg, KY 41653 621757927-01
Jackson Purchase Medical
Center
761.89 Mayfield, KY 42066 (Formerly Pinelake Medical Center) 610510934-00
James B. Haggin Memorial Hospital
1,042.21 Harrodsburg, KY 40330 610595335-00
Jane Todd Crawford Memorial
Hospital
403.41 Greensburg, KY 42743 953956120-00
Jenkins Community
Hospital
612.67 Jenkins, KY 41537 (Formerly First Health Jenkins, Inc.) 610482973-00
Jennie Stuart Medical Center,
Inc.
733.48 Hopkinsville, KY 42240 611029768-05
Jewish Hospital,
Inc.
1,088.47 Louisville, KY 40202 611029768-14
Jewish Hospital -
Shelbyville
780.87 Shelbyville, KY 40066-1089 (Formerly United Medical Center) 611285331-00
Kentucky River Medical
Center
700.48 Jackson, KY 41339-5170 (Formerly Middle KY River Medical Center) 522085561-01 Kindred Hospital Louisville 940.761313 St. Anthony Place Louisville, KY 40204 (Formerly Vencor Hospital) 610444716-00
King’s Daughters’ Medical
Center
798.60 Ashland, KY 41101 610566292-00
Knox County
Hospital
628.49 321 High Street, Box 260 Barbourville, KY 40906 621757920-00
Lake Cumberland Regional Hospital
602.06 P. O. Box 620 Somerset, KY 42501 (Formerly Columbia Lake Cumberland Regional Hospital) 610518022-MD
Livingston County Hospital,
Inc.
657.13 Salem, KY 42078 621757917
Logan Memorial
Hospital
765.11 Russellville, KY 42276 (Formerly Columbia Logan Memorial Hospital) 610600313-00
Lourdes
Hospital
771.53 Paducah, KY 42002 610927491-00
Marcum and Wallace Memorial
Hospital
1,035.06 Irvine, KY 40336 610601267-00
Marshall County
Hospital
691.55 Benton, KY 42025 610475281-00
Mary Chiles
Hospital
823.27 Mount Sterling, KY 40353 611140447-00
Marymount Medical Center,
Inc.
863.05 London, KY 40741 520795508-09
McDowell Appalachian Regional
Hospital
663.54 610974433-00
Meadowview Regional Medical
Center
711.05 Maysville, KY 41056 (Formerly Columbia Hospital Maysville) 610920842-01
The Medical
Center
690.49 Bowling Green, KY 42101 610920842-07
The Medical
Center
690.49 Scottsville, KY 42164 (Formerly Allen County War Memorial Hospital) (Merged with Medical Center at Bowling Green) 061255960-00
Mediplex at Bowling
Green
639.81 Bowling Green, KY 42104 610594620-00
Memorial Hospital,
Inc.
621.67 Manchester, KY 40962 610461753-11
Methodist
Hospital
739.76 Henderson, KY 42420 (formerly Community Methodist Hospital) 520795508-12
Middlesboro Appalachian Regional
Hospital
585.16 Middlesboro, KY 40965 310949874-00 Monroe County Medical Center 354.92529 Capp-Harlan Road Tompkinsville, KY 42167 520795508-10
Morgan Appalachian Regional Health
Care
972.03 West Liberty, KY 41472-0545 (Referred to as Appalachian Regional Health Care) 610445841-01
Muhlenberg Community
Hospital
685.93 Greenville, KY 42345 610620567-00
Murray Calloway County
Hospital
670.65 Murray, KY 42071 610646583-00
Nicholas County
Hospital
718.75 Carlisle, KY 40311 610703799-07
NKC
1,219.23 Louisville, KY 40232 Suburban, and Southwest Hospital) (Formerly Alliant Health System) 610678588-04
Norton Audubon
Hospital
1,095.38 Business Office LL2 Louisville, KY 40217 (Formerly Columbia Audubon Hospital) 610703799-36
Norton Springview
Hospital
730.45 P. O. Box 820 Lebanon, KY 40033 (Formerly Columbia Springview Hospital) 311131099-00
Ohio County
Hospital
740.00 Hartford, KY 42347 611356023-00
Our Lady of Bellefonte Hospital
810.45 Saint Christopher Drive Ashland, KY 41101 611012503-00
Our Lady of the Way
Hospital
1,043.02 Martin, KY 41649 611286361-00
Owensboro Mercy Health
System
810.00 Owensboro, KY 42304 (Formerly Owensboro Daviess County Hospital) 611218106-02
Parkway Regional
Hospital
546.71 Fulton, KY 42041 610461940-00
Pattie A. Clay
Hospital
851.01 Richmond, KY 40475 610301300-00
Paul B. Hall Regional Medical
Center
844.16 P. O. Box 1487 Paintsville, KY 41240 610458376-01
Pikeville Methodist
Hospital
815.03 Pikeville, KY 41501 610541901-01
Pineville Community
Hospital
542.16 Pineville, KY 40977 610444702-00
Regional Medical
Center
795.92 610523304-00
Rockcastle Hospital and Respiratory
Care
316.13 Mount Vernon, KY 40456 (formerly Rockcastle County Hospital) 611351267-00
Russell County
Hospital
609.89 Russell Springs, KY 42642 610605336-01
St. Claire Medical Center
777.34 Morehead, KY 40351
610445850-02
St. Elizabeth Medical
Center
822.04 Covington, KY 41014 610445850-03
St. Elizabeth Medical
Center
822.04 Edgewood, KY 41017 611334601-01
St. Joseph
Hospital
1,069.68 Lexington, KY 40504 611334601-00
St. Joseph Hospital
East
715.19 Lexington, KY 40509 610486447-00
St. Luke Hospital
East
783.16 Fort Thomas, KY 41075 611171698-00
St. Luke Hospital
West
679.56 Florence, KY 41042 621606156-02
Samaritan
Hospital
761.54 Lexington, KY 40508 (Formerly Samaritan Medical Center/Columbia Hospital Lexington) 610703799-31
Southwest
Hospital
719.29 Louisville, KY 40272 (Formerly Columbia Southwest Hospital) 610678588-07
Suburban
Hospital
783.24 Louisville, KY 40207 (Formerly Columbia Suburban Hospital) 610676546-00
Taylor County
Hospital
734.28 Campbellsville, KY 42718 611238190-00
Three Rivers Medical
Center
693.23 Louisa, KY 41230 (Formerly Humana Hospital Louisa) 610461767-01
T. J. Samson Community
Hospital
641.19 611226399-00
Tri-County Baptist
Hospital
741.37 610471581-00
Trigg County Hospital,
Inc.
797.86 610523298-00
Twin Lakes Regional Medical
Center
619.86 610461753-03
Union County Methodist
Hospital
827.01 Morganfield, KY 42437 616001218-03
University
Hospital
1,208.80 Lexington, KY 40536 610703210-00
University of KY Hospital Medical 530 South Jackson Street Only Louisville, KY 40202 611293786-00
University of Louisville
Hospital
1,170.48 530 South Jackson Street Louisville, KY 40294 (Formerly Humana Hospital University) 610847215-00
Wayne County Hospital,
Inc.
610.58 Monticello, KY 42633 610444707-02
Western Baptist
Hospital
786.85 Paducah, KY 42001 610974165-00 Westlake Regional Hospital 1,312.00P. O. Box 468 Columbia, KY 42728 520795508-01
Whitesburg Appalachian Regional
Hospital
688.17 Whitesburg, KY 41858 520795508-24
Williamson Appalachian Regional
Hospital
563.44 South Williamson, KY 41503 Woodford Memorial Hospital (This Hospital has been deleted from our files.)
SERVICE FEE MEMORANDUM Date: March 27, 2000 UPDATE: December 10, 2002RE: Disproportionate Share Hospital (DSH) Service [formerly Kentucky Hospital Care Program (KHCP)]When an individual is dually eligible for the Disproportionate Share Hospital (DSH) Services and Kentucky Department of Vocational Rehabilitation (DVR) services, Dennis Boyd, Commissioner of the Kentucky Department for Medicaid Services, has confirmed that the Disproportionate Share Hospital (DSH) Servicesis the first payer when funds are available. Consumers should apply for DSH prior to their scheduled hospital stays. The DVR pay documentshould only be issued when the consumer has been found not eligible for DSH services or the hospital’s allotment has been depleted. The current resource and income limits as well as all other conditions that an individual must meet for the DSH Services can be found on the Kentucky Cabinet for Health Services web site at Department for Medicaid Services, Disproportionate Share Hospital (DSH) Services, DSH Application, Section II. DSH allotments cover the state fiscal year. A hospital holding its DSH allotment for individuals not dually eligible for DVR is not justification for DVR coverage of hospital services. DSH is considered a comparable benefit for physical restoration services. Federal regulation mandatesthat all available comparable benefits be fully utilized prior to the expenditure of vocational rehabilitation dollars. The memorandum from Commissioner Boyd is attached. A copy of
this memo may be given to any
SERVICE FEE MEMORANDUM MS-CE-02-03-04
MS-JT-99-00-31
ORIGINAL DATE: JULY 1, 2000 UPDATE: AUGUST 1, 2000/SEPTEMBER 1, 2000 AMENDED: FEBRUARY 1, 2002
RE: HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM RATE SCHEDULE AND OUTPATIENT HOSPITAL SERVICES.
HOSPITALIZATION: AMENDED INPATIENT HOSPITAL PER DIEM RATE SCHEDULE AND OUTPATIENT HOSPITAL SERVICES This Amended Hospital Per Diem Rate Schedule is being issued to update inpatient per diem rates for twenty-eight (28) hospitals. Corrections in Vendor Numbers, Hospital Names, Addresses, and Per Diem Rates are being bolded and underlined. A hard copy of this SERVICE FEE MEMORANDUM will not be mailed to you. The updated hospital per diems are effective for service dates on or after February 1, 2002. If you have issued any pay documents at old inpatient per diem rates for February service dates, you may adjust to the updated per diems prior to invoicing for payment. I apologize for any inconvenience that this may cause you. It took longer than anticipated to update this schedule since numerous names, address, and vendor number changes had to be completed on the Case Management System. Cover Pages 1 and 2 are not in the Case Management System. You should therefore maintain a hard copy of these pages in your Service Fee Memorandum binder. Pages 3 - 13 contain information pertaining to Inpatient Per Diem Rates which are in the Case Management System, Option 31, off the Case Management System Menu. It is therefore optional that you maintain a hard copy of these pages in your Service Fee Memorandum binder. INPATIENT HOSPITALIZATION Coverage at the inpatient per diem rates times the number of days of hospitalization. Non-allowable charges include admissions kit, television rental, personal items, telephone, etc. OUTPATIENT HOSPITALIZATION Outpatient Surgery If Pre-Admissions Tests are performed on date(s) prior to the consumer’s scheduled outpatient surgery date, hospital charges for such tests should be authorized at the established Relative Value Schedule (RVS).
Diagnostic Services Coverage for outpatient diagnostic (evaluation and management, medicine, radiology, and pathology) services will be at Relative Value Schedule rates. Emergency Room Coverage for emergency room visits will be provided accordingly: Diagnostic Procedures: Relative Value Schedule Rates DISPROPORTIONATE SHARE HOSPITAL (DSH) formerly KENTUCKY HOSPITAL CARE PROGRAM (KHCP) When a consumer eligible for both DSH and DFB/DVR, DSH is the first payer when funds are available. Consumers should apply to DSH prior to their scheduled inpatient or outpatient hospital stays. University Hospital in Lexington does not participate in outpatient services. The DFB/DVR pay document should not be issued to the hospital until the consumer’s eligibility for DSH is determined.
Woodford Memorial Hospital
SERVICE FEE MEMORANDUM
DATE: July 23, 2001
RE: Inpatient Hospital Per Diem Rate Schedule
The correct vendor number, address, and per diem rate for Norton Springview Hospital (listed as Springview Hospital on the Hospital List) is:
610703799-36 Norton Springview Hospital $ 730.45 320 Loretto Road P. O. Box 820 Lebanon, KY 40033
The correct vendor number, address, and per diem rate for University of Louisville Hospital is:
611293786-00 University of Louisville Hospital $1,185.17 P. O. Box 70115 530 South Jackson Street Louisville, KY 40202
MS/vy
SERVICE FEE MEMORANDUM MS-99-00-31
ORIGINAL DATE: July 1, 2000 UPDATE: August 1, 2000 RE: HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM RATE SCHEDULE AND OUTPATIENT HOSPITAL SERVICES
UPDATE: SERVICE FEE MEMORANDUM MS-99-00-31, HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM RATE SCHEDULE AND OUTPATIENT HOSPITAL SERVICES, is effective August 1, 2000.
This Hospital Per Diem Rate Schedule is being issued to update inpatient per diem rates. A hard copy of this SERVICE FEE MEMORANDUM will not be mailed to you.
The updated hospital per diems are effective for service dates on or after August 1, 2000. If you have issued any pay documents at old inpatient per diem rates for July service dates, you may adjust to the updated per diems prior to invoicing for payment.
I apologize for any inconvenience that this may cause you. It took longer than anticipated to update this schedule since numerous name, address, and vendor number changes had to be completed through the MARS system. Cover Pages 1 and 2 are not in the Case Management System. You should therefore maintain a hard copy of these pages in your Service Fee Memorandum binder.
Pages 3 - 13 contain information pertaining to Inpatient Per Diem Rates which are in the Case Management System, Option 31, off the Case Management System Menu. It is therefore optional that you maintain a hard copy of these pages in your Service Fee Memorandum binder.
UPDATE SERVICE FEE MEMORANDUM MS-99-00-31
ORIGINAL DATE: July 1, 2000 UPDATE: August 1, 2000
RE: HOSPITALIZATION: INPATIENT HOSPITAL PER DIEM RATE SCHEDULE AND OUTPATIENT HOSPITAL SERVICES
INPATIENT HOSPITALIZATION Please find attached an updated Inpatient Hospital Per Diem Rate Schedule effective August 1, 2000. Authorizations already issued for services rendered on or after August 1 should be adjusted to reflect the per diem rates on this new schedule. Non-allowable charges include admissions kit, television rental, personal items, telephone, etc.
OUTPATIENT HOSPITALIZATION Outpatient Surgery If Pre-Admissions Tests are performed on date(s) prior to the consumer’s scheduled outpatient surgery date, hospital charges for such tests should be authorized at the established Relative Value Schedule (RVS).
Diagnostic Services Coverage for outpatient diagnostic (evaluation and management, medicine, radiology, and pathology) services will be at Relative Value Schedule rates.
Emergency Room Coverage for emergency room visits will be provided accordingly: Diagnostic Procedures: Relative Value Schedule Rates Emergency Room, Recovery Room, Drugs, and Supplies: By Report
KENTUCKY HOSPITAL CARE PROGRAM (KHCP) When a consumer eligible for both KHCP and DFB/DVR, KHCP is the first payer when funds are available. Consumers should apply to KHCP prior to their scheduled inpatient or outpatient hospital stays. University Hospital in Lexington does not participate in outpatient services. The DFB/DVR pay document should not be issued to the hospital until the consumer’s eligibility for KHCP is determined.
(Changes updated on July, 23, 2001)
MS-99-00-22
DATE: March 27, 2000 RE: Kentucky Hospital Care Program (KHPC) When an individual is dually eligible for the Kentucky Hospital Care Program and Kentucky Department of Vocational Rehabilitation (DVR) services, Dennis Boyd, Commissioner of the Kentucky Department for Medicaid Services, has confirmed that the Kentucky Hospital Care Program (KHCP) is the first payer when funds are available. Consumers should apply for KHCP prior to their scheduled hospital stays. The DVR pay document should only be issued when the consumer has been found not eligible for KHCP services or the hospital's allotment has been depleted. I understand that KHCP allotments cover the state fiscal year. A hospital holding its KHCP allotment for individuals not dually eligible for DVR is not justification for DVR coverage of hospital services. KHCP is considered a comparable benefit for physical restoration services. Federal regulation mandates that all available comparable benefits be fully utilized prior to the expenditure of vocational rehabilitation dollars. The memorandum form Commissioner Boyd is attached. A copy of this memo may be given to any hospital that is questioning DVR not paying for hospital services. Feel free to contact me with any questions or concerns.
January 26, 2000
MEMORANDUM
To: Marian Spencer, Program Administrator Department of Vocational Rehabilitation Workforce Development Cabinet
From: Dennis Boyd, Commissioner Department of Medicaid Services Cabinet for Health Services Re: Kentucky Hospital Care Programs (KHCP) This memorandum is in response to your November 24, 1999 correspondence regarding who is the first payer, KHCP or the Department of Vocational Rehabilitation (DVR), for acute care hospital mental and physical restoration services if an individual is dually eligible for KHCP and DVR services. KHCP is the first payer when funds are available. This decision is in accordance with the Kentucky Medicaid Program State Plan under Title XIX of the Social Security Act, which states Title XIX funds will be used first to pay for medical services, within the scope of the Medicaid program, which are a part of the plan of treatment and rehabilitation of individuals eligible for Title XIX benefits. If there are additional questions concerning this issue, please contact Ms. Sharon Walter of my staff at 564-6240. c: Sharon Walter file
SERVICE FEE MEMORANDUM MS-95-96-6
DATE: January 11, 1996 RE: Outpatient Hospitalization Surgery The Department of Vocational Rehabilitation (DVR) coverage of outpatient surgery is discouraged. In most situations, outpatient hospitalization as opposed to inpatient hospitalization for surgery becomes much more costly to the agency since DVR pays a daily per diem when an inpatient admission, but 65% of actual billed charges when an outpatient admission. Only when 65% of the estimated outpatient hospital charge will be less than the daily inpatient per diem should outpatient surgery be considered. When a surgery is being scheduled, the physician should be asked to schedule an inpatient admission. A pre-authorization to a hospital with the inpatient daily per diem(s) does not insure that an inpatient admission will occur. Should the physician be reluctant to schedule inpatient, you may need to explain that current budgetary constraints necessitate this. An explanation of how this agency covers outpatient and inpatient hospital charges may also be of benefit to the physician.
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