It was always my understanding when the ABN policy was issued that it was to apply to items and services that were ordered by the physician that Medicare was pretty sure not to cover. It did not seem to apply to the typical notices of non-coverage related to initiation or continuation of skilled care in the SNF. I must agree with Winona that I find it hard to understand that CMS would so radically change the procedure without notice to providers.
----- Original Message ----- From: Winona M. Phelps <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, November 20, 2003 9:19 PM Subject: RE: determination on continued stay. > Hi Theresa. Thank you for this posting. I've read the information and keep > coming back to the form itself. The 2 options on the bottom of the form > just don't make any sense to me. As far as ending skilled coverage, the two > options on the Medicare Denial of Benefits form have always been choices > between wanting a demand bill or not wanting one. These two choices on the > 10055 are between wanting to receive services and not wanting to receive > services. Those are four very different questions. I don't understand why > CMS would have so basically changed this procedure?? > I would love to hear thoughts on this. > Thanks, > Winona Phelps > > -----Original Message----- > From: Theresa A Lang [mailto:[EMAIL PROTECTED] > Sent: Thursday, November 20, 2003 4:46 PM > To: [EMAIL PROTECTED] > Subject: RE: determination on continued stay. > > > The entire non-coverage letter form and process changed on 10-1-03 with the > issuance of the CMS Electronic manual system. > > The new required form CMS 10055 can be found in the CMS Claims Processing > Manual, Chapter 30, Sections 40 and 70. It is about 30 pages total and is a > significant change from the old non-coverage letters found in the SNF 12 > Manual. > > http://cms.hhs.gov/manuals/104_claims/clm104index.asp > > from this site select Chapter 30- then go to sections 40 and 70 > > I did attach a pdf copy of the CMS 10055 > > Theresa Lang > Specialized Medical Services, Inc > Milwaukee WI > > > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Sue > Junot > Sent: Thursday, November 20, 2003 1:52 PM > To: [EMAIL PROTECTED] > Subject: determination on continued stay. > > > sorry but I am bain dead today. can someone please direct me to INFORMATION > covering "DETERMINATION ON CONTINUED STAY,DETERMINATION OF NONCOVERAGE,AND > DETERMINATION ON ADMISSION" > THANKS, > SUE, RAC-C > > _________________________________________________________________ > Say "goodbye" to busy signals and slow downloads with a high-speed Internet > connection! Prices start at less than $1 a day average. > https://broadband.msn.com (Prices may vary by service area.) > > /---------------------------------------------------------- > 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 > -----------------------------------------------------------/ > > /---------------------------------------------------------- > 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 > -----------------------------------------------------------/ > /---------------------------------------------------------- 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 -----------------------------------------------------------/
