For your private insurances covering TKR's etc, you need to have precerted and know that insurance is truly going to pay. You need to also find out from them what they need in the way of documentation to support their coverage. I have several that require medicare assessments. Also, for some of mine that also have part a and I am not sure the insurance is going to pay, then I go ahead and do the medicare assessments just in case.
For respite residents, you are only required to do OBRA assessments. I would also call my insurance company and ask what they need. For the resident that went back to the hospital, what was his pay status? If he was medicare a, you would do a 5 day assessment on him, then do a d/c tracking coded 8 (I take it that this was a new admission, so you would code this as discharged prior to completion of initial assessment). When you returns, you restart you medicare pps schedule with a medicare readm/return assessment, followed by 14 day, etc. You will also need to complete your OBRA admission assessment by the 14th day. Brenda W. Chance, RN, RAC-C MDS Coordinator CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: katie fox [mailto:[EMAIL PROTECTED] Sent: Thursday, January 29, 2004 11:05 AM To: [EMAIL PROTECTED] Subject: private insurance I have a question about the schedule for residents with private insurance. I have had a lot of residents with total knee replacements with private insurance. What is the requirement? Most are only here for 7-10 days. What assessment do I do? Also, are respite patients the same as private insurance? Last question, I had a resident come in for rehab after total hip replacement. He was not here even 24 hours and went back to the hospital. We anticipate his return. What do I do in this situation? Thank you everyone! Katie Fox, RN Sea View Nursing and Rehabilitation Facility 7500 Bolongo Bay St. Thomas, Virgin Islands 00802 340-777-3303 ext. 114 _________________________________________________________________ MSN 8 helps eliminate e-mail viruses. Get 2 months FREE*. http://join.msn.com/?page=features/virus /---------------------------------------------------------- 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 -----------------------------------------------------------/
