Instinct EMR and Instinct Treatment Plan automatically calculate hospitalization charges so your practice doesn't have to track them manually. Choose from three billing options to match how your practice handles hospitalization timing and production tracking.
Before you begin
To select or change a hospitalization level, open the checked-in patient's Tx Sheet and use the Hospitalization drop-down in the upper right corner.
Option 1: Rolling hospitalization
Best for: Practices that want hospitalization charges to begin immediately and to repeat based on the patient's admission date.
Rolling hospitalization is a charge that starts at the hour a hospitalization level is selected and repeats automatically every 12 hours (q12h) until the patient is checked out or until the level changes.
For example, if a patient is hospitalized at 1:00 PM with a q12h level, charges automatically occur at 1:00 PM, 1:00 AM, 1:00 PM, and so on until discharge.
Steps for success:
Each 12-hour charge has a quantity of 1—no need to fractionate charges.
Label the hospitalization level clearly, for example: Hospitalization (1-12 hours).
Optionally, create corresponding levels—such as Nursing Care, Isolation, ICU, or Fluid Pump Charges—that automatically apply alongside the hospitalization charge.
Sample hospitalization charges with added Nursing Care automatic charge q12
Note: Charges fall at the time the level was first selected. If Doctor A admits a patient at 1:00 PM and Doctor B takes over at 8:00 PM, Doctor B won't receive production credit until the 1:00 AM charge. Some practices are comfortable with this approach; others prefer charges that align with shift changes.
Option 2: Shift-timed hospitalization
Best for: Practices that want hospitalization charges to occur at consistent times each day, aligned with provider shifts, regardless of when the patient was admitted.
Shift-timed hospitalization charges at fixed times configured for your practice—for example, always at 8:00 AM and 8:00 PM. A one-time setup fee is charged immediately when a hospitalization level is selected, covering the period before the first scheduled charge.
For example, if a patient is hospitalized at 2:00 PM and your practice charges at 8:00 AM and 8:00 PM, the first recurring charge occurs at 8:00 PM. The setup fee covers the hours between 2:00 PM and 8:00 PM.
Steps for success:
Each hospitalization charge still has a quantity of 1.
Create a one-time Hospitalization Setup Fee that charges when the level is selected. Price it similarly to the q12h charge to cover the initial hours before the first shift charge.
Label levels clearly, for example: Hospitalization (1-12 hours) and Admit and Hospitalize to ICU.
Sample hospitalization charges with added Nursing Care automatic charge q12 and initial Admin/Set Up one-time charge
Note: Because charges occur at fixed times, staff may naturally wait until just before a billing time to discharge patients. Establishing a clear discharge schedule throughout the day helps prevent this.
Option 3: Hospitalization starting at check-in
Best for: Practices that consider hospitalization to begin when the patient arrives, rather than when a hospitalization level is officially selected.
With this option, hospitalization charges are retroactively calculated from the patient's check-in time rather than from the time the level is selected. For example, if a patient checks in at 9:00 AM and a q12h hospitalization level is selected at 1:00 PM, billing begins at 9:00 AM, and the next charge falls at 9:00 PM.
This retroactive start applies only to the first hospitalization level selected during a visit. Any subsequent level changes take effect when they are selected.
Note: Options 2 and 3 are global clinic settings—your practice must use one or the other for all hospitalization levels. It is not possible to apply Option 2 to some levels and Option 3 to others. This option may not suit practices that prefer to start billing when a patient is officially hospitalized rather than at initial check-in.
Choosing the right workflow
Use this table to find the option that best fits your practice's billing and production model.
If your practice wants to… | Recommended option |
Begin charging immediately and repeat at a set interval | Option 1: Rolling Hospitalization |
Align charges with provider shifts or scheduled billing times | Option 2: Shift-Timed Hospitalization |
Start billing from the patient's check-in time | Option 3: Hospitalization Starting at Check-In |
Best practices
Regardless of which workflow your practice uses:
Use clear, descriptive names for hospitalization levels so staff can quickly select the right level.
Keep hospitalization quantities at 1 for each billing interval—never fractionate charges manually.
Automate related charges (such as nursing care, ICU monitoring, or isolation fees) so nothing is missed.
Review provider production expectations before selecting a workflow—especially if providers share cases across shifts.
Standardize your team's hospitalization and discharge process to ensure consistent billing across shifts.
Frequently asked questions
Can I use different options for different levels of hospitalization?
No. Options 2 and 3 are global clinic settings—all hospitalization levels at your practice will use the same option. Option 1 (rolling) does not share this restriction.
Do I still need to manually calculate partial hospitalization charges?
No. Each hospitalization interval is billed as a quantity of 1, so there is no need to fractionate charges regardless of which option your practice uses.
What happens if I change a patient's hospitalization level mid-stay?
The new level starts when it is selected. The exception is Option 3: only the very first level of the visit retroactively starts at check-in. All subsequent level changes start at the time of selection.
Can I add other charges alongside a hospitalization level?
Yes. With any option, you can configure automatic charges—such as Nursing Care, ICU Monitoring, or Fluid Pump Fees—that apply whenever a hospitalization level is selected.
Which option is most commonly used?
There is no single best option. The right workflow depends on your practice's billing policies, provider production model, and operational preferences. Discuss your workflow with the Instinct team to determine the best fit.
Still need help?
Contact support via live chat or email [email protected].