Instructions for Completing Comprehensive Diagnostic and Treatment Centers Report

 

article 28 diagnostic and treatment center

Terms Used In New York Laws > Public Health > Article including, but not limited to, a general hospital, public health center, diagnostic center, treatment center, dental clinic, dental dispensary, rehabilitation center other than a facility used solely for vocational rehabilitation, nursing home, tuberculosis hospital. Hospitals and Diagnostic and Treatment Centers (Clinics) in New York State. The Division of Hospitals and Diagnostic and Treatment Centers (D&TCs) is under the statutory authority of Article 28, Section of the Public Health Law (PHL), and Title 10 of the New York Codes of Rules and Regulations (NYCRR), Section This dataset contains the locations of Article 28, Article 36 and Article 40 health care facilities and programs from the Health Facilities Information System (HFIS). Article 28 facilities are hospitals, nursing homes, and diagnostic treatment centers. Article 36 facilities are certified home health care agencies and long term home health care programs.


Diagnostic and Treatment Center (Clinic), Operating Certificate - NYC Business


Since you are not precluded from submitting reports electronically for periods prior to the date mandated by law, we encourage you to electronically file for reporting periods prior to January 1, Providers are required to file the Provider Certification Form and the two most recent service year portions of the Report of Patient Services Revenue and Article 28 diagnostic and treatment center Obligations monthly, even if there is no activity to report.

Revenue received during the month for surchargeable claims for services rendered during a prior service year must be reported in the appropriate service year. Additionally, adjustments to information previously reported for such service years must be reported as prior period adjustments in the appropriate service year.

Once all claims have been adjudicated, article 28 diagnostic and treatment center, the provider must submit a final monthly report along with a completed DOH - Provider Status Change form indicating the effective date when all claims were adjudicated. As a result, monthly reports filed by providers must be segregated article 28 diagnostic and treatment center service period portions. For example, providers must include revenue received for services provided in in the portion of the report even though the revenue was received in a subsequent service period.

Note that the guidance offered in these instructions is not all-inclusive. Please refer to the New York Health Care Reform Acts and related correspondence previously disseminated by the Department which is available on the Web. Column A - Description : This column itemizes total net patient services revenue received, including surcharges. Column B - Current Month :.

This column is to be used for reporting total net patient services revenue received during the report article 28 diagnostic and treatment center, including surcharges. If there are no prior period adjustments to report in Column C, do not complete this column. See Column D instructions. Column C - Prior Period Adjustment : This column is to be used for reporting adjustments due to a reporting error or omission in a prior month. This may be either a positive or negative adjustment.

Denote negative amounts with brackets. Detailed records must be maintained since all report information is subject to audit. Column D - Total : Add the individual amounts reported in Column B to the respective amounts reported in Column C and enter the result on the appropriate line in Column D, article 28 diagnostic and treatment center.

If there were no prior period adjustments in Column C, total net patient services revenue received during the month may be entered in Column D only. In general, net patient services revenue shall mean all moneys received for or on account of hospital or medical services provided or related to patients whose purpose is the treatment or prevention of human illness, disease, injury or disability. Providers should refer to the Line 1 instructions for a more specific definition for net patient services revenue for diagnostic and treatment centers providing a comprehensive range of primary health care services PHL Section j.

It should be noted that certain grants and other revenue would be included and may be considered assessable if representing moneys received for the provision of care or other health-related services to individuals. Note however, that government deficit financing grants are never assessable. Such deficit financing grants would be included in Line 1 and then shown as non-assessable on Line 2 g. Line 1 - Total Net Patient Services Revenue Received, including surcharges : Enter total net patient services revenue received during the report month, including surcharges be sure to include grant article 28 diagnostic and treatment center on this line.

This amount should also include recoveries received from accounts receivable previously written off as uncollectible. Net patient services revenue includes assessable and non-assessable patient services revenue.

Net patient services revenue must be reported in the article 28 diagnostic and treatment center in which it is received. Pursuant to Section j 3 b of the Public Health Law, net patient services revenue for diagnostic and treatment centers providing a comprehensive range of primary health care services shall mean all moneys received for or on account of all services, including capitation payments allocable to diagnostic and treatment center services otherwise covered by the assessment, less refunds, for or on account of visits made or services performed on or after January 1,or contracted service obligations for periods on or after January 1, This section of the Public Health Law applies to all service periods subsequent to Line 2 - Non-Assessable Revenue : Report non-assessable net patient services revenue received during the report month according to the following categories.

Line 2 a - Report payments related to Medicare eligible beneficiaries on this line. This applies whether Medicare is the primary payor or the secondary payor. Also to be included are related co-payment, deductible and coinsurance revenue received, article 28 diagnostic and treatment center. However, revenue received from payors including patients making payments to a designated provider where Medicare benefits have exhausted for a particular service or for an uncovered service, shall be subject to all applicable surcharges.

Include related co-payment, deductible and coinsurance revenue received. Line 2 c - Report payments received for contracted services performed for other designated providers on this line. Example: A freestanding Article 28 comprehensive clinic has a contractual agreement with an Article 28 general hospital to perform certain x-ray services. The Article 28 diagnostic and treatment center surcharges do not apply to the amount the freestanding Article 28 comprehensive clinic bills and receives in payment from the Article 28 general hospital.

Note that this would include uncovered services as well as covered services. Line 2 e - Effective January 1,physician practice or faculty practice plan revenue based on discrete billings for private practicing physician services would be reported on this line. This refers to situations where a designated provider processes discrete billings for a private practicing physician service or faculty practice plan, article 28 diagnostic and treatment center.

Effective with dates of service April 1,and after, this line also includes discrete billings for physician services. This refers to situations where a designated provider processes discrete billings for an employed physician or a physician practice or faculty practice plan. Line 2 g - Report grants including governmental deficit financing on this line. Line 2 h - Other - Include all other non-assessable patient services revenue received during the report month, which is not reportable on Lines 2 a through 2 gon this line.

Additionally, report here certain payments made directly by New York State and its local governmental subdivisions that are non-assessable. Refer to the instructions for Lines 5 a5 b and 5 c for assessable payments received directly from New York State and its governmental subdivisions.

Line 2 i - Revenue received for or on account of referred ambulatory laboratory clinic visits made or services performed on or after October 1,is reported on this line. Referred ordered ambulatory care laboratory services are defined as clinical laboratory services provided to non registered patients i. For purposes of the specific service being ordered for a specific patient, article 28 diagnostic and treatment center, the specified provider ordering the service may not be employed by or under contract to provide direct patient care for the facility.

Net patient services revenue received from direct pay payors must be segregated into the following categories:. The amount reported in Column D, Line 7 must be segregated into the categories listed in Column A, Lines 8 through 12 of the corresponding service period report. Column B - Total Assessable Revenue, including surcharges : This column is to be used to report total net patient services revenue received from non-direct pay payors during the article 28 diagnostic and treatment center month Column D, Line 7 of the corresponding service period report.

Column C - Surcharge Factor : This column provides the appropriate surcharge factor for each class of non-direct pay payors shown in Column A, Lines 8 through See Line 11 for non-specified payor example. Also report payments received from non-electing approved organizations for services provided to subscribers eligible for the Family Health Plus Program pursuant to Title D of Article 5 of the Social Services Law.

In addition, report co-pay or deductible patient payment amounts on this line that are NOT reportable on Line Please see instructions for Line Line 10 would also include secondary payor co-pays, deductibles, and coinsurance amounts where the primary payor is an electing payor but the secondary payor is a non-electing payor.

The freestanding Article 28 comprehensive clinic is providing a surchargeable service for the nursing facility non-specified payor. The HCRA surcharges apply to the bill the comprehensive clinic submits to the nursing facility. Since the nursing facility is not a specified payor pursuant to Public Health Law and is therefore not required to make an election to make pool payments directly, only the surcharge s applies. This would include any payor specified under Public Health Law as being allowed to remit pool payments directly which has not made article 28 diagnostic and treatment center election.

Note also that this would include patient and secondary payor co-payment, deductible and coinsurance amounts where the primary payor is a non-electing payor. This amount must equal the amount reported in Column D, Line 7 of the corresponding service period report. All other co-pay and deductible patient payments for which written notification has NOT been provided, must be reported on Line Navigation menu.

Linear Descriptions Note : Refer to Report for applicable surcharge percentage. Questions or comments: bimamail health. Your browser does not support iFrames.

 

Hospitals and Diagnostic and Treatment Centers (Clinics) in New York State

 

article 28 diagnostic and treatment center

 

Diagnostic and Treatment Centers (D&TCs), issued an operating certificate pursuant to Article 28 of the Public Health Law (PHL), providing a comprehensive range of primary health care services are required to submit reports electronically for reporting periods on and after January 1, by. Medical Billing and Article 28 - A Short Guide. What is article 28 medical billing software, and why is it necessary? Depending on where you are in the country and how much you have heard about medical billing and coding laws, you may have heard about Article Article 28 is a New York State public health law which recognizes and regulates. Rahma Health Clinic Article Diagnostic Treatment Center Regional Primary Care Network Article Diagnostic Treatment Center Rome Memorial Hospital Article Diagnostic Treatment Center Samaritan Home Health Inc Article Home Care Agency and Program Samaritan Keep Nursing Home Inc Article Nursing Home.