What is meant by the 3-day payment window rule?

The 3-day payment window rule refers to a regulation that stipulates how certain outpatient services should be handled when they are provided within a specific timeframe—specifically, three days prior to an inpatient admission. This rule is intended to bundle related outpatient services with the resulting inpatient stay; the services must be combined into a single claim to ensure that payment reflects the entire episode of care.

By consolidating these outpatient services with the inpatient claims, it encourages hospitals to manage patient care more efficiently and reduces the potential for duplicate billing. This is particularly important in ensuring that healthcare facilities are reimbursed appropriately for the continuum of care provided during a patient's hospital stay. The correct answer aligns with this understanding of the regulation's aim and operations within the revenue cycle management framework.