Inpatient Claim
What is an inpatient claim?
An inpatient claim is a medical bill submitted by a healthcare facility, such as a hospital, for inpatient services. Generally, inpatient services are those provided to a patient who is admitted to a facility for treatment. Examples of facilities that submit inpatient claims include:
- Acute-care hospitals
- Long-term care hospitals
- Psychiatric hospitals
- Rehabilitation hospitals
- Skilled nursing facilities (SNFs)
- Skilled home health care
- Hospice care
An inpatient claim contains unique medical codes that reflect the care provided to a patient while admitted. These medical codes may encompass the following:
- Diagnoses
- Procedures
- Length of stay (LOS)
- Medical devices
- Medical supplies
- Medical transportation
- Pharmaceutical drugs
Why are inpatient claims important for healthcare?
Inpatient claims are medical bills containing all services and care the patient received while admitted to the hospital. The inpatient’s insurance provider then assesses the medical codes to determine the reimbursement amount to the provider for their services. Inpatient claims are a crucial step in facilities receiving payment for the care they provide.