Instinct automatically calculates hospitalization charges and supports multiple workflows so clinics can choose the option that best fits staffing, shift coverage, and billing preferences.
Use this article to understand each hospitalization workflow, how charges are applied, and which option may work best for your clinic.
Rolling Hospitalization
Rolling hospitalization applies a recurring charge every 12 hours starting from the time the hospitalization level is selected.
How it works
A q12h hospitalization charge starts at the exact time it is selected.
Charges automatically post to the invoice every 12 hours after that.
Charges continue until the patient is checked out or a different hospitalization level is selected.
Example: If hospitalization is selected at 1:00 PM, charges will post at 1:00 PM and 1:00 AM.
Steps for success:
Each 12 hour hospitalization charge has a quantity of “1”, so no more fractionating these charges.
Label the hospitalization level clearly, such as “Hospitalization (1 to 12 hours)”
Optional: Create corresponding levels, including nursing, isolation, ICU, or fluid pump charges that can be automated with it.
Potential challenge:
Production credit follows the charge timing. Doctors taking over a case mid-cycle may not see production until the next scheduled charge.
This “what goes around comes around” approach may not work for all clinics.
Shift-timed Hospitalization
Shift-timed hospitalization applies charges at fixed times aligned with shift changes and includes a one-time setup fee.
How it works
Hospitalization charges post at predefined times (for example, 8:00 AM and 8:00 PM), regardless of when the level is selected.
A one-time Hospitalization Setup Fee is charged immediately when the hospitalization level is selected.
The setup fee covers the time between selection and the next scheduled charge.
Example: If hospitalization is selected at 2:00 PM, the setup fee posts immediately and the first recurring charge posts at 8:00 PM.
Steps for success:
Set recurring hospitalization charges with a quantity of 1.
Create a one-time setup fee that triggers automatically with the hospitalization level.
Label levels clearly (for example: Hospitalization (1–12 hours) and Admit and Hospitalize to ICU).
Price the setup fee similarly to the 12-hour hospitalization charge, if appropriate.
Potential Challenge:
This can lead to doctors unintentionally batching discharges between the busy 6 pm to 8 pm hour daily but this is easy to overcome with workflow (ie, schedule your discharges).
Hospitalization starting at check in
This option allows hospitalization charges to begin based on the patient’s check-in time rather than when the hospitalization level is selected.
How it works
The first hospitalization selected retroactively starts at the patient’s check-in time.
Subsequent hospitalization changes start at the time they are selected.
Step for success:
Note that you may only select Option 2 or Option 3 as a global clinic setting (we are unable to accommodate one hospitalization level with Option 2 and another as Option 3).
Potential Challenge:
This may not be the best option if you begin charging for hospitalization when the patient is actually hospitalized rather than when they initially check-in.