1. (Hospital) Sends HFS 117, Hospital Statement, to Bureau of Claims Processing for inpatient services provided.
  2. (Hospital) Sends separate HFS 117s when multiple treatments are given.
  3. (Hospital) Sends monthly bill on hospital letterhead or own billing form, for outpatient or home dialysis.
  4. (Hospital) Includes in bill for outpatient services:
    • case name,
    • patient's name,
    • case ID number,
    • dates of services, and
    • charge per treatment.
  5. (HFS) Pays an all-inclusive rate for outpatient dialysis including:
    • doctor fees,
    • other professional charges,
    • supplies,
    • lab work,
    • charges for equipment,
    • drugs,
    • chest x-ray,
    • EKG,
    • shunt,
    • operating room charges, and
    • anesthesia.
  6. (Doctor) Sends HFS 132, Physician's Statement of Services Rendered, to Bureau of Claims Processing for payment for non-routine services.