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How Hospitals Can Recoup Revenue on Resident-rendered Services

HealthLeaders Media Staff, January 18, 2011

be as billable 'at home' as they are when the resident is moonlighting elsewhere," writes R. Lawrence Reed, II, MD, of thedepartment of surgery at Indiana University and the department of trauma services at Clarian Methodist Hospital in Indianapolis.

He calls the paper's concept "ingenious" and asks why the industry follows CMS rules in situations when CMS is not involved. He notes that "for the 45 years since Medicare was introduced, hospitals have given away a massive fortune in free care provided by residents to privately insured patients."

One question is whether the private insurers would just deny the claims. They could, Feinstein says, "but on what ground would they deny the claim?"

When he first presented the paper, it was controversial. But he thinks the concept has potential. "It will take a courageous hospital or training program to give it a shot. I'm curious to see what insurers will say and do."

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