Option 1 is the old demand bill.

Option 2 is the patient/family agrees with you.

This is the standard format used by HHA, DME, Part B therapy services, etc.
It is a change of format we just get to "get over" the change and move
forward with. Asking CMS to change will not happen.

Theresa Lang
Specialized Medical Services, Inc
Milwaukee WI

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Winona M. Phelps
Sent: Thursday, November 20, 2003 8:20 PM
To: '[EMAIL PROTECTED]'
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

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/----------------------------------------------------------
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
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