I work for a Behavioral Health MCO (managed care organization). It has been a standard practice for us to deny any professional claim where a physicians see's a patient in the hospital if there is not a Hospital Claim to support those charges. I'm trying to find out documentation that supports that practice. Can't seem to find it on the DMA website or DHHS. Does anyone have any idea where I can find this information?
Inpatient claim to Support Professional Charges for Behavioral Health
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