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MedicaidAdministrativeMedium impact

22-575 Avoid Denials and Include Inpatient Discharge Hour on Final Claims

Health Net·CA·Provider News
Effective date
Jul 6, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net now requires the discharge hour (DHR) to be included on all inpatient claims when reporting specific patient discharge status codes. Claims missing the discharge hour will be rejected and must be resubmitted with the complete information.

Action Required

Action needed
Immediately: Billing team must update inpatient claim submission procedures to include discharge hour (DHR) for all 837I encounters with patient status codes 01, 02, 03, 04, 05, 06, 07, 09, 20, 21, 40, 41, 42, 43, 50, 51, 61, 62, 63, 64, 65, 66, 69, 70, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95 when type of bill ends in xx1, xx4, or xx7. Review and resubmit any previously rejected claims missing DHR information. Claims without discharge hour will be rejected.