We verify all patients insurance before admission whether Medicare or Managed Care, etc. We do a 14 day Admission MDS on all patients (including Managed Care if here 14 days or >). We do not do the PPS MDS schedule for Managed Care patients and have never had an issue in almost 6 years since we opened our SNU. I think clear documentation of verification of benefits may be the key for us. However, we have never had an issue with a Managed Care patient acutally turning out to be a Medicare patient. I do agree that your MDS load would be much greater if you followed the PPS schedule for everyone. Sorry I don't really have any words of wisdom, just my experience.
-----Original Message-----
From: [EMAIL PROTECTED] on behalf of BONNIE RANDOLPH
Sent: Mon 11/3/2003 8:30 PM
To: [EMAIL PROTECTED]
Cc:
Subject: Managed Care HMOs/Assessments
What do others do about the managed care resident's assessments? We keep
them on a Medicare schedule, just for a safety net because we have gotten
"stuck" several times finding out too late that a Medicare resident
disenrolled from Medicare and joined the Managed Care HMO. It wasn't really
a concern until just lately when the majority of our admissions are Managed
Care HMOs. It seems a waste of MDS time doing the extra assessments but if
they save us even once from a default rate, I guess they are worth the time.
Opinions?
Bonnie
_________________________________________________________________
Crave some Miles Davis or Grateful Dead? Your old favorites are always
playing on MSN Radio Plus. Trial month free!
http://join.msn.com/?page=offers/premiumradio
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
<<winmail.dat>>
