Okay.... maybe I didn't ask this quite right. I'll try again... but it's late, and I'm at home now.
First - we are talking about the non-Medicare portion of our facility. (We are distinct part). This has nothing to do with whether they qualify or not for Medicare reimbursement.
When a Medicaid resident chooses to stay in a private room when a semiprivate room is available, we are allowed to charge them the difference between either the 1) private vs semiprivate rate, or 2) private rate vs Medicaid reimbursement - - whichever is LESS for the resident.
In this case, we are required to put the resident in a private room regardless of census. We do not plan to charge the resident for the difference of course. But one of our staff thought she had read something, or heard at a seminar, that in this case we could pre-certify with Medicaid for reimbursement for the private room. Although I had never heard of anything like this, I thought it was just worth asking if any of you have ever heard of it.
I prefer no stripes please.....
They make me look fat.
(haha)
dfrias <[EMAIL PROTECTED]> wrote:
Sure there are a number of ways....but my question then will be to you....what way do you want your stripes....horizonal or vertical.All kidding aside....if the medical necessity is there....yet the resident has not met the criteria for MC benefits d/t no hospitalization then you have a Medicaid resident in a private room for 6 weeks....and in my former facility....if this resident likes the room....they stay. Some little regulation called Resident Rights. HUMMMMMMMMMMMmmmmmmThe Nose----- Original Message -----From: Linda BuddeSent: Wednesday, November 05, 2003 3:53 PMSubject: Private room - Billers?Could someone tell me off the top of their head if there is a way to get additional reimbursement for a Medicaid resident that must be in private room due to medical necessity for 6 weeks? (Non-Medicare bed). (Resident is receiving chemo tx in bladder - precautions necessary). We are in KS.
Linda Budde, RN
Reimbursements
Friendly Acres, Inc.
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Linda Budde, RN
Reimbursements
Friendly Acres, Inc.
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