Wed Jan 24, 2007 2:06 pm                                   Taken By: DANIEL 
BLAIS (5667 IN)
We are having an issue with patients whom are registered more than once on the 
same day.
Being a Critical Access hospital, Medicare prevents us from sending more than 
one TOB 851
claim for the same service date. They ultimately pay the first claim and deny 
the second.
Problem is when a patient is in ED in the morning and requires Labs in the 
afternoon,
(registered twice on same day) we need to combine charges/Dx's. In B/AR, we are 
not able to
add Dx's, as system prevents us from doing so, Coding has compliance issues 
with adding
DX's from one acct to another. How do other sites handle this issue, in order 
to merge
accts and only send one TOB 851 claim per service date.

For Dan Blais

--
Howard Chase, RN
Androscoggin Valley Hospital
59 Page Hill Road
Berlin, NH 03570
(603)326-5669
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