Charge Sheet

[Wayne47]

Recently my facility is trying to introduce a charge sheet for any procedures the nurse preforms. I have never heard of this before. I wanted to upload a picture of one but I couldn't. Basically if we do one of these procedures we mark in on the sheet so that they can charge the patient for it. I don't know anything about billing but I didn't think it worked this way.

Examples of things it has on there include

insert midline

CAVH-D

Blood Glucose via Clucometer

ACT Test

Collect Blood from PICC

Wound Care

Remove chest tube

Is this a common thing at other facilities? What I find weird it that is was a new member of administration who is pushing us to do this not the billing department.

[LifelongNursing, MSN, RN, APRN, NP]

It is uncommon, but not out of bounds. It all depends on what the facility can charge and not charge under the "nursing" side of things that typically comes with the charge for the hospital room for the day/night. I used to work for a facility that wanted to charge the patient just for bladder scanning them.

[CalicoKitty, BSN, MSN, RN]

It is uncommon, but not out of bounds. It all depends on what the facility can charge and not charge under the "nursing" side of things that typically comes with the charge for the hospital room for the day/night. I used to work for a facility that wanted to charge the patient just for bladder scanning them.

Doesn't your bladder scanner tell you how much you've saved from scanning?

[TigraRN]

At our facility, we only use charge sheets for foleys, c-collars, slings, crutches/walkers/canes, and other supplies. It can get tiring to fill out all those BG checks and blood draws, glad we don't have to use the sheets for that.

[LifelongNursing, MSN, RN, APRN, NP]

Doesn't your bladder scanner tell you how much you've saved from scanning?

Indeed, but I disagree about the charge. It is part of the nursing reasoning and assessment when the patient is post Foley, or has an acute change in urine output.

[EllaBella1, BSN]

My hospital does that. We use Cerner and the things we're supposed to charge for trigger a task on the task list. So like for glucose checks it triggers at whatever times/frequencies they are ordered. When you double click on it it asks for which finger you poked (and obviously I always just pick the first option on the list), and you sign it and that's it. Same thing with blood draws, line draws, etc. When you sign off on your lab labels it triggers a task on your task list and you just go in and sign those tasks and it automatically charges. Much easier than having to keep track of what you do that should be a charge.

[psu_213, BSN, RN]

In the ED, we charged individually for things that are not included in the regular ED visit rate. We charge for things like blood draws, straight caths, splints/slings, continuous pulse ox monitoring, conscious sedations, bags of IV fluids. I worked at one place where we had charge sheets, and the nurse was supposed to fill one out for each patient--the secretary would then enter the charges into the pt's electronic chart. At another ED, a secretary would review each discharged pt's chart and then fill out the charge form in the charge form in the chart based on physician orders and nursing documentation.

As for administration pushing for it, not billing--this administrator was probably told by finance (or someone else above him/her) to start accounting for these charges. It appears that the push is coming from the administrator, but it likely started above him/her. Or, this person's marching orders when they started was to work on the budget and he/she sees this as a place for improvement.