Wisconsin: Interim payment for long length of stay

Hospitals may interim bill for inpatient claims if the member has been an inpatient at the hospital for more than 60 days.

• UnitedHealthcare Community Plan of Wisconsin requires claims to be submitted for interim payment with patient status code "30" (still a patient) in Item 22 of the UB-04 Claim Form

To receive final payment for the claim, submit an adjustment to the original claim.

If additional interim payments are necessary, submit a corrected claim for the subsequent requests. At least 30 additional days are required to elapse since the "through" date on any previous claim or adjustment. Write "interim payment for long length of stay" as the adjustment reason. Attach an updated UB-04 Claim Form to the request. On the updated UB-04 Claim Form include:

• A current patient status code in Item 22
• All accumulated charges since admission (not just the additional charges since the first interim payment)
• All other updated information showing all events up to the "through" date on the claim (e.g., additional surgical procedure codes, new discharge diagnosis)

Learn more
For more information about the requirements and to complete the state forms, sign in to the ForwardHealth Portal.

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