Medicare reimbursement question?

Question

You're and inpatient coder in a hospital. You've just coded a Medicare Part A record with a diagnosis-related group reimbursement of $12,000. You notice in the hospital's computer billing system that the patient's charges are $19,500. That's $7,500 more than the hospital will be reimbursed. How does the difference between the charges and the DRG reimbursement become resolved?

Answer 1

If medicare's DRG is $12000, the hospital can balance bill the sub for the $7500, or the hospital can write off the remainder as paid in full. This is why medicare supplements policies can be important for the elderly.