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Hospital final bill format for Administration

[Music] welcome all of you to a new episode of our uh short videos so uh today I would like to talk about the legality issues uh in uh Healthcare billing setup we get a lot of questions uh from hospitals that what all services can they build to the patients on their uh name and which they cannot so uh uh coming back to the you know Basics first uh whenever we apply for a clinical establishment ACT registration or Bombay nursing home ACT registration or as relevant for your state we always uh are supposed to provide our premises details uh doctor's details are there but however the premises details in terms of fire Noy and building Plan Building approval so uh understand that your Hospital registration is for the premises and when you apply for an empanelment with insurance companies or with ECS or cghs that time also the premisis is what gets onboarded uh and the doctor uh is onboarding is not very relevant in this case so the treatment can be done by any Doctor Who is a licensed practitioner uh however the treatment has to be conducted at the premisis of that particular registered hospital now in this case uh I'll uh there are a lot of examples where uh a hospital does not have a particular facility but they have anou with some other third party which is located outside the premises uh to conduct that particular test or treatment or any procedure so beware that any such kind of an agreement uh does not override your agreement with the insurance company or ECS cghs uh all the treatment which is done in your premises is supposed to be built by you and any treatment done outside your premises is supposed to be built by that particular party although that bill can be submitted by you but however the bill cannot be raised by you I'll give you uh two three examples uh for example a hospital ABC has a patient uh with some CVA uh and requires an MRI scan now this MRI scan might not not be available in that particular hospital so the hospital will send the patient to some other uh uh Center for MRI scan and get the patient back here the MRI scan was not performed at the place at the premises of Hospital ABC so in this situation Hospital ABC is not supposed to raise a bill for it directly however they can always attach a bill from the other uh Center wherever the MRI was done as one of the additional Services similarly uh in oftalmology uh there is uh there's a practice in which a lot of hospitals do not have an Ayer laser so they take their patient to some other third party center where they do the exam laser and bring the patient back to their own Center in such cases also the build processing cannot be return from your hospital so uh where the care and the service delivery has started and ended at your premises in your own premises you are allowed to build so uh nowadays there's a lot of scrutiny which is happening uh where uh the uh hospitals builds in terms of refractive surgery especially being looked upon uh where any Hospital which does not have a refractive surgery setup at their own premises uh they are legally not supposed to uh raise a bill for it now uh been going on that the bill used to be accepted but however when scrutinized then uh the bill does not uh stand scrutiny so uh it is my uh suggestion uh to the people who are watching this video that issue bills only for the services that is provided at your center now one more thing is uh there are a lot of Investigations or outsourced laboratory services which you undertake at your Center uh you have a eye up with somebody to come collect the blood sample and carry the blood uh test somewhere else and give you a report later in such situations is the blood sample collection and the start of the service delivery has happened in your hospital your hospital can generate a bill for it uh if you have a third party device uh like a yag laser or an OC which is coming on call and doing the investigation at your premises you are legally allowed to generate a bill for it however if that same you are going to send the patient physically to a third place then uh that particular Bill cannot be generated by a hospital it has to be generated by the place where the procedure or the investigation has been done in such cases uh in case the bill gets rejected from the insurance company uh there is actually no valid argument which we can give even an mou does not stand a chance the reason being that uh all your permissions licenses and the responsibility so uh this word is very important where is a responsibility Now understand that a healthcare bill is a very important document so even even for the next 7 years if the patient wants to fire a you know negligence or a deficiency service complaint the bill is a biggest uh document uh which establishes that the patient has availed a particular service from your premises so uh imagine you have send the patient to the third party center and there's a deficiency service in the third party center and you have issued a bill from your premises so the entire responsibility of even the machine maintenance and any errors in the equipment will also be pinned on to the person who issued the bill so there uh you will be answering for the shortcomings of a separate entity which I don't think any doctor would prefer to do or Hospital would prefer to do so in this uh very simply uh the final statement would be that kindly issue bills only for the services that is provided in your premises if you're providing a third uh the services at a third party center which is different from your premises kindly issue the bill from that place so uh that's it and one more thing I would like to mention is that uh we are coming up with a short webinar of 1 hour on this Wednesday that is 24th of January evening 8:00 onwards in which we'll be talking about cashless ement process uh with a particular one particular health insurance company which is Care Health insurance so uh see you there uh I'll leave the link in the description sign up uh it's uh it's available on YouTube as well as Zoom so that will be very interesting uh session uh so see you there uh until next time [Music] goodbye