tci Medicare Compliance & Reimbursement - 2013 Issue 23

Emergency Medicine Billing: Get Paid for Emergency Services You Provide to Patients in Custody

Set up a reasonable system for remuneration related to ED care. In the Centers for Medicare & Medicaid Services’ (CMS) recent clarification of existing CMS policy regarding patients in legal custody, the description of “prisoner” seems quite broad. Excluding those actually “imprisoned” in a long term corrections facility; the remainder of these patients typically get their more serious care in the ED. The paradox for ED providers is that they face a combination of an EMTALA mandate to screen for emergency medical conditions and at least stabilize or transfer the patient and a federal regulation prohibiting payment...

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