Observation vs Inpatient: Maximizing Reimbursement for Hospital Stays

By Marc Chapman

The way work comp patients are classified as “observation” or “inpatient” can have an effect on the amount the hospital is reimbursed. We reviewed one claim that was classified and billed as an inpatient to a work comp carrier, where the patient was in the hospital a total of 4 hours.

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Health Care Costs

High-Deductible Plans Are a Growing Problem for Both Patients and Hospitals

The enrollment in high-deductible health insurance plans is becoming more and more commonplace as employers are searching for ways to curb their ever increasing spend on healthcare benefits for their employees.  Employees covered under high-deductible health plans find themselves spending more out of pocket on healthcare than ever before as more of the financial responsibility is shifted to them.

A recently released Kaiser survey reported that in 2006 only 4% of employees in employer sponsored health benefit plans were enrolled in high-deductible plans where today 20% are enrolled in these plans.  That is a significant increase.  The launch of the Affordable Care Act in 2014 is expected to further raise the number of enrollees in high-deductible plans.

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Insurance Bankruptcy Signs

Impending Issues with Increased Enrollment in High-Deductible Health Insurance Plans

Here is a concerning thought…As many Americans enroll for health insurance coverage under the Affordable Care Act (ACA), a large percentage may choose to enroll in the high-deductible health insurance plans associated with low monthly premiums offered through the exchanges.  What is going to happen when these patients receive bills from their hospitals and doctors that they cannot afford to pay?

While there has already been an uptick over the last decade in enrollment in high-deductible plans by insured Americans, many analysts foresee that the numbers will increase exponentially in 2014 and beyond with the enactment of the ACA.

The plans we reviewed on the exchanges for 2014 offered deductibles between $1000 and $6350.  Even with good intentions of choosing a plan that is affordable, a low income family could easily find it difficult to Read more


Our FINAL FOUR Top Recommendations for Winning the Game Against High Cost Hospital Bills

When it comes to collegiate basketball, the best of the best compete in March Madness with hopes of making it to the Final Four.

When it comes to the niche of Specialty Bill Review, one of the best services in the nation is Chapman Consulting, LLC.

With March Madness picking up steam this month, we have compiled a Final Four list for you to consider
when preparing for surgery or when you encounter high dollar or MADDENING hospital bills anytime of the year.

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That’s NOT FAIR!!!! How can the hospital charge this much??

Have you ever felt like saying this when you saw the charges on your hospital bill?

We hear it every day from individuals, our attorney clients, insurance companies and third party administrators.  We see it every day in national news.  The bills are actually shocking!

The health care system we have today in the United States is extremely complicated.  There is no easy fix.  In fact, we feel the system is increasingly more complicated and expensive even with health care at the forefront of politics in America

So what can you do??  Who can help?? Read more