Emerging Nurse Billing and Reimbursement Models.

Journal

The Journal of nursing administration

ISSN: 1539-0721

Titre abrégé: J Nurs Adm

Pays: United States

ID NLM: 1263116

Informations de publication

Date de publication:
09 Aug 2024

Historique:

medline: 9 8 2024

pubmed: 9 8 2024

entrez: 9 8 2024

Statut: aheadofprint

Résumé

To explore and make recommendations to implement direct billing and reimbursement models for nursing care in the United States. Nurses make up the largest group of healthcare professionals and within hospitals, nurses represent approximately a quarter of all resources and associated costs of patient care. This care is mostly hidden in daily room and board charges. The authors surveyed the recent and historical literature related to costing and billing for nursing care. These results were synthesized and led to the recommendation of several new models to cost, bill, and pay for nursing care provided by nurses who are not currently billing for their services. Two basic billing models are proposed: the 1st is to remove nursing care out of the current daily room or facility-based charges and allocate nursing care time provided to each patient during each day of stay. The 2nd is to expand existing Current Procedural Terminology codes to bill for specific activities and interventions by nurses in all settings where nursing care is delivered. It is feasible to implement the proposed methods to identify patient-level nursing intensity, cost, services, and interventions provided by individual nurses in all healthcare settings.

Sections du résumé

OBJECTIVES OBJECTIVE

To explore and make recommendations to implement direct billing and reimbursement models for nursing care in the United States.

BACKGROUND BACKGROUND

Nurses make up the largest group of healthcare professionals and within hospitals, nurses represent approximately a quarter of all resources and associated costs of patient care. This care is mostly hidden in daily room and board charges.

METHODS METHODS

The authors surveyed the recent and historical literature related to costing and billing for nursing care. These results were synthesized and led to the recommendation of several new models to cost, bill, and pay for nursing care provided by nurses who are not currently billing for their services.

RESULTS RESULTS

Two basic billing models are proposed: the 1st is to remove nursing care out of the current daily room or facility-based charges and allocate nursing care time provided to each patient during each day of stay. The 2nd is to expand existing Current Procedural Terminology codes to bill for specific activities and interventions by nurses in all settings where nursing care is delivered.

CONCLUSIONS CONCLUSIONS

It is feasible to implement the proposed methods to identify patient-level nursing intensity, cost, services, and interventions provided by individual nurses in all healthcare settings.

Identifiants

DOI: 10.1097/NNA.0000000000001456 PMID: 39120146

pubmed: 39120146

doi: 10.1097/NNA.0000000000001456

pii: 00005110-990000000-00079

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

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