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Rule making Hearing Rules
of
The Tennessee Department of Labor and Workforce Development
Division of Workers Compensation
Chapter 0800218
Medical Fee Schedule
New Rules
Table of Contents
0800218.01
0800218.02
0800218.03
0800218.04
0800218.05
0800218.06
0800218.07
0800218.08
0800218.09
0800218.10
0800218.11
0800218.12
0800218.13
0800218.14
0800218.15Medicarebasis
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How to fill out this inpatient hospital fee
How to fill out this inpatient hospital fee
01
Obtain the inpatient hospital fee form from the hospital's billing department.
02
Fill in your personal information, including your full name, date of birth, and contact details.
03
Provide details of your health insurance coverage, including the insurance company name and policy number.
04
Indicate the dates of your hospital stay, including the admission and discharge dates.
05
Break down the costs incurred during your stay by listing the services provided, such as room charges, medical procedures, medications, and laboratory tests.
06
Calculate the total amount due by adding up all the costs mentioned in step 5.
07
Sign and date the form, indicating your agreement to pay the specified amount.
08
Submit the completed form to the hospital's billing department for processing.
Who needs this inpatient hospital fee?
01
Anyone who has received inpatient hospital services and needs to submit a claim or request for reimbursement
02
Individuals who are self-paying for their hospital stay
03
Patients with health insurance coverage who need to provide proof of expenses for insurance claims purposes
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What is this inpatient hospital fee?
The inpatient hospital fee is a fee charged for services provided during a hospital stay.
Who is required to file this inpatient hospital fee?
Hospitals are required to file the inpatient hospital fee.
How to fill out this inpatient hospital fee?
The inpatient hospital fee can be filled out online through the designated portal provided by the healthcare authorities.
What is the purpose of this inpatient hospital fee?
The purpose of the inpatient hospital fee is to collect revenue to support hospital operations and ensure quality patient care.
What information must be reported on this inpatient hospital fee?
The inpatient hospital fee must include details of the services provided, length of stay, and total charges incurred.
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