responses to hospital contract question
JOY CHARLTON
Description
Collection
Title:
responses to hospital contract question
Creator:
JOY CHARLTON
Date:
12/17/2007
Text:
I got a lot of great responses to my original question regarding hospital contracts/self pay inpatients and a lot of requests to share the responses, so here there are, anonymously...
Thanks to everyone that replied!Joy W. CharltonOffice ManagerCentral Texas Orthotics and Prosthetics, LP
This is always a nasty situation. The discharge planner in these cases canbe your greatest ally. They are personally responsible to ensure safe andappropriate discharge or transfer to other facilities. If the patient cannotbe discharged safely without the OP device the hospital may be required tokeep that patient until they are safe to discharge. This is a situationwhere the physicians will probably not help you and may require a consistentmessage from all your OP colleagues in the area. We tactfully contacted the discharge planners, before we had a crisis, andadvised them of the change in hospital policy and the potentialimplications. They then went to bat for us because it placed the burden uponthem. It did take a small crisis, indigent patient fell ended up with a mild butpainful compression fracture. We withheld brace fitting pending financialclearance. He could not be discharged by the facility without the brace, MDrefused to right DC order, hospital refused to issue PO on Wednesday,discharge planner could not locate a facility to accept patient. Patient wasdelighted to remain in the hospital, warm bed, hot showers, cute nurses,three meals per day. Hospital relented issued PO the following Thursday,seven days after initial injury, brace fitting occurred and patient D/C onehour later. CFO contacted me directly and tried to read me the riot act,failure to provide services, etc, etc. I then asked how much they mark upour invoices for cost reporting purposes and resubmission to other carriers.(270%!) We politely pointed out that even if he gets paid for only one infive of my invoices they are still breaking even. ( I have documented thisover the years as patients complained about the hospital bill to theirinsurer, I requested a copy) Have not had a problem since. This approach requires a very strong relationship with referral sources anddirect, immediate reaction when it occurs. It must also be done veryselectively to have maximum effect.
Thanks to everyone that replied!Joy W. CharltonOffice ManagerCentral Texas Orthotics and Prosthetics, LP
This is always a nasty situation. The discharge planner in these cases canbe your greatest ally. They are personally responsible to ensure safe andappropriate discharge or transfer to other facilities. If the patient cannotbe discharged safely without the OP device the hospital may be required tokeep that patient until they are safe to discharge. This is a situationwhere the physicians will probably not help you and may require a consistentmessage from all your OP colleagues in the area. We tactfully contacted the discharge planners, before we had a crisis, andadvised them of the change in hospital policy and the potentialimplications. They then went to bat for us because it placed the burden uponthem. It did take a small crisis, indigent patient fell ended up with a mild butpainful compression fracture. We withheld brace fitting pending financialclearance. He could not be discharged by the facility without the brace, MDrefused to right DC order, hospital refused to issue PO on Wednesday,discharge planner could not locate a facility to accept patient. Patient wasdelighted to remain in the hospital, warm bed, hot showers, cute nurses,three meals per day. Hospital relented issued PO the following Thursday,seven days after initial injury, brace fitting occurred and patient D/C onehour later. CFO contacted me directly and tried to read me the riot act,failure to provide services, etc, etc. I then asked how much they mark upour invoices for cost reporting purposes and resubmission to other carriers.(270%!) We politely pointed out that even if he gets paid for only one infive of my invoices they are still breaking even. ( I have documented thisover the years as patients complained about the hospital bill to theirinsurer, I requested a copy) Have not had a problem since. This approach requires a very strong relationship with referral sources anddirect, immediate reaction when it occurs. It must also be done veryselectively to have maximum effect.
Citation
JOY CHARLTON, “responses to hospital contract question,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/228846.
