Instinct is designed to automatically calculate hospitalization charges for you, with a few different options to accommodate any unique workflows.
Table Contents
Option 1 – Rolling Hospitalization
Option 2 – Shift-Timed Hospitalization
Option 3 – Hospitalization Starting at Check In
Common Hospitalization Workflows Quiz
Selecting a Hospitalization Level
The hospitalization drop-down is found in the upper right of the Tx Sheet.

Common Hospitalization Workflows
Option 1 – Rolling Hospitalization
This is a simple q12h hospitalization charge that starts during the hour it is selected from the drop down menu, and falls onto the invoice automatically every 12 hours thereafter.
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.
Above: Sample hospitalization charges with added Nursing Care automatic charge q12
Potential challenges:
- Hospitalization charges fall onto the invoice based on the time it was initially selected. For example, if a patient is hospitalized at 1pm with a q12 hospitalization frequency, the charges will take place at 1pm and 1am until the patient is checked out or another hospitalization level is selected. This means doctors who take over cases mid-hospitalization level (starting your shift at 8pm) will not get production until the next charge comes due (1am in this case). This is a “what goes around comes around” approach which may not work for all clinics.
Option 2 – Shift-Timed Hospitalization
This is similar to option 1, but hospitalization levels have set times based on shift changes with an initial admit/set up fee hitting the invoice immediately. For example, we can set your hospitalization to always charge at 8am and 8pm (or any other time interval) so charges drop into the invoice automatically at these times. This means if a hospitalization level is selected at 2pm, the first hospitalization charge would be applied at 8pm. The initial set up fee covers the first (and potentially lost) hours before the next 8am and 8pm so doctors are still getting credit for that time.
Above: Sample hospitalization charges with added Nursing Care automatic charge q12 and initial Admin/Set Up one-time charge
Steps for success:
- Each hospitalization still carries the exact quantity of “1” (no fractionating charges), with a one-time “Hospitalization setup fee” that automatically charges one-time when the hospitalization is selected.
- Label these hospitalization levels clearly, such as, “Hospitalization (1 to 12 hours)” and “Admit and Hospitalize to ICU”. As a reminder, the setup fee is a one-time charge and can be priced similarly to the q12h hospitalization charge.
Potential Challenges:
- 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).
Option 3 – Hospitalization Starting at Check In
This option requires some careful planning but you can set hospitalization levels to begin when the patient checks in to your hospital.
For example, if a patient checks in at 9am and you select a q12h “Hospitalization Level 1” at 1pm, this hospitalization charge will retroactively begin at 9am instead of 1pm. The next charge will automatically take place at 9pm, which is the next scheduled 12h frequency. This will only happen for the first hospitalization that is selected and once a hospitalization is set, subsequent changes to the hospitalization will start at the time the hospitalization drop down is chosen.
Steps 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 Challenges:
- 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.
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