Revenue Cycle

MAC settles long-running inpatient billing debate

Recovery Auditor Report, May 19, 2011

Editor's note: This article originally appeared on the Case Management Mentor blog.

Noridian Administrative Services LLC, Medicare administrative contractor (MAC) for Montana, North Dakota, South Dakota, Colorado, Utah, and Arizona, has put to rest the question of how hospitals should bill for patients who are improperly referred for observation services when they actually met inpatient criteria.

Noridian provided the answer as part of a list of inappropriate admission orders in a May 6 announcement. The example is as follows:

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