PATIENT CHARGES – AN OVERVIEW

PATIENT CHARGES – AN OVERVIEW

• What are Patient Charges and what does it contain?

Patient charge is nothing but the fees claimed by the physician who rendered the services to the patient. Charges can be either based upon demographic evaluation or a flat fee rate as prescribed by the physician’s office. Each piece of information is important because correct and quality entry of such information will directly impact physician’s monthly revenue. This sheet is also called as face sheet of a charge or claim.

• How Charge Sheets originate and reach us?

Once patient /spouse completes Pd sheet, patient is then referred to physician in the appointed time. After preliminary investigation physician provides the services required by the patient. In the super-bill, kind of treatment is denoted by procedure code and diagnosis code denotes the nature of illness for which services were administered.
Super bills or charge sheets contain information like Date of Service, Kind of Service, Diagnosis Code, Attending Doctor, Modifier details. Super bills are usually completed by physician or their assistant. Sometimes Coding of diagnosis & procedures are done by coding specialists.
Once Charge sheets are completed, they are batched with PD at physician’s office and are forwarded to our office for charge entry. Mode of transfer of data may vary from client to client. But most preferred mode is thru FTP. Here patient demographics are scanned & captured as image file. These image files are placed in FTP site. These image scan files are retrieved at our office & charge entry begins.

• For our easy understanding now let us see each of the information found in patient charge sheet. Information found in patient charge sheet is 1. Attending Physician 2. Referring Physician 3. Admit Date 4. Date of Service 5. Type of Service 6. Place of Service 7. Prior Authorization Number 8. Modifiers 9. Procedure code 10. Diagnosis Code 11. # Of days/ units, 12. Location Details 13. Physician Name, Address, Provider id

1. Attending Physician: Attending physician is also referred as rendering physician. A physician who renders the service to patients is called attending or rendering physician. Each Rendering/Attending Physician of a particular facility is assigned a unique code with the Name of the Physician, Address of the Clinic/Facility, PIN (Provider Identification Number), License number, Federal TaxID#.

The Rendering Physician Name, Address, and PIN are printed in the 33rd field and if the Address of the Facility where the service was rendered differs from the Physicians location then that address is printed in the 32nd field and the corresponding Federal Tax ID of the Provider is printed in the 25th field of CMS-1500 form.