Reminder: Hospital transfer policy

We’d like to remind you of Blue Cross Blue Shield of Michigan’s policy on transferring a patient from one hospital to another. When patients are discharged or transferred to another hospital, please indicate the appropriate discharge disposition as follows:

• 02 (Discharged/transferred to another short-term general hospital)
  
  or

• 07 (Left against medical advice or discontinued care). 

You would enter the discharge disposition on the UB-04 claim form in locator 17 (Patient Discharge Status). The transferring hospital should receive full payment only when the patient’s length of stay meets or exceeds the maximum number of days allowed under the diagnosis related group assigned to the admission.

If a patient is transferred to a second hospital prior to using all days allowed at the first hospital, the transferring hospital should receive only a per diem payment based on the length of stay.

The Blues review paid claims from the previous year to identify patients who were discharged or transferred to another acute care facility. You will receive a letter if we identify claims that may be transfers. If you agree, we’ll adjust your payment. If you disagree, you’ll need to follow the directions on the letter and send in your documentation. Either way, you’ll receive a letter notifying you of our decisions.

For multiple transfers, you may want to refer to the article in the January 2010 Record.