[cassioo]

I'm wondering what other hospitals are doing for observations patient charges. To add to our nursing paperwork the powers that be have decided that nursing should do the charges for observation (23 hr hold) patients. It's getting really rediculious the rules that keep changing...we do nurse eval so that's a charge but if the doc says watch them longer observation time starts, IV fluid time, IV pushes but a medication only counts once so if someone got a push in ER we don't count the same medication even if we push it 10 times, IVPB because IV fluid doesn't count if it's there for access and not theraputic and if they come from OR they really aren't observation they are extensions of recovery room so that time doesn't count and we don't bill for that...it just goes on and on. I think they should hire some clerical staff at that wage to review the charts and charge away. We can get a talking to if we miss charges but if you charge something wrong it's also fraud and abuse and you can get in trouble from the government for that...I have patients to take care of with enough paper work. What does your hospital do?

[cassioo]

am I the only one in the country that has to do this?

[cougarnurse]

Cass, let me find out from one of the local hospitals here.....

'Cat'

[cassioo]

Thanks, I figure if you have computer charting it's an automatic but if your still stuck in the paper era someone is doing it I think it's a clerical job that someone could be reviewing charts to capture those charges instead of nursing