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Hospital Billing Guidelines

Office of PolicyHospital Billing Guidelines Applies to dates of discharge and dates of service on or after September 1, 2021 Revised 7/26/2021 Page 2 of 98 TABLE OF CONTENTS New Changes for 9/1/2021 .. 6 Billing OVERVIEW .. 8 Provider Enrollment .. 9 UB-04 Instructions for Hospital Providers .. 9 CASES Billing INSTRUCTIONS .. 13 Transfer Billing ..13 Transfer between Acute Care and Medicare Distinct Part Psychiatric Units .. 13 Multiple Transfers between Acute Care and Medicare Distinct Part Psychiatric Units .. 14 Transfers between Acute and Distinct Part Rehabilitation Units .. 15 Interim Billing Instructions ..15 Adjustments to Paid Claims ..16 Denied/Problem Claims ..17 Pre-Certification, Prior Authorization Requirements, and Utilization Review ..17 Pre-Certification Psychiatric Admissions .. 17 Prior Authorization Medical and Behavioral Health.

Sep 01, 2021 · ODM Hospital Billing Guidelines are based on rules of the Ohio Administrative Code (OAC). Effective July 1, 2015, ODM is no longer publishing transmittal letters or utilizing eManuals, including the Ohio Department of Job and Family Services (ODJFS) Legal Policy Central Calendar.

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