Estimating Hospital Billing Revenues
On discharge, each case is assigned a DRG that best reflects the inpatient hospital care provided to the patient and therefore, the reimbursement the hospital will receive for inpatient care.
The team must understand the hospital’s normal practice for splitting DRG revenue from patients transferred between units. For example, revenue can be prorated between the originating unit and the palliative care unit based on charges or based on days. Once the practice is determined, algorithms should be developed to estimate expected DRG revenue from inpatient units for program planning and to make the continuing financial case.