Mortality GIP
Good afternoon,
Trying to understand the billing process with GIP admissions (I don't need GIP qualifying information, that is easier to find :) ).
When a patient admits to a Medicare certified acute care bed as GIP status... if the patient expires... Does the hospital issue a TOB 11x with DC disposition of 20, but it isn't paid normally since Hospice is the primary payer? And simultaneously Hospice issues a TOB 82x.
Is the reason a bill is submitted to show CMS how many days they should be reimbursed at the GIP per diem rate? Does CMS pay the hospital or the Hospice?
If Hospice pays the facility, why would the hospital submit TOB 11 and DC disposition of 20? what is the purpose?
The bill type part is all new to me, so I am trying to make sense of it. This came up when CDI asked why the DC disposition on the GIP hospital bill (several times a back-to-back IP admit to GIP admit) wasn't 41. We were told the TOB 11 is correct and DC disposition is 20 because 41 can only be used on the hospice bill (and the second GIP coding statement, isn't the hospice bill).
If it isn't the hospice bill, what would the point be in creating a separate bill, that can't be paid because hospice is primary and in charge of billing?
Hopefully someone can follow me here, it's been a struggle to get clarity.
Thank you!!
Ann
Annnd2009@gmail.com