RE: demand billing

[Ann Schoeny]

You need to do an omra and continue to assess him on a medicare schedule.He will likely be eligible for more medicare. This has happened to us and we just rescind the Medicare cut. -----Original Message----- From: Deb Wilmhoff [mailto:[EMAIL PROTECTED] Sent: Saturday, January 31, 2004 4:56 PM To: [EMAIL PROTECTED] Subject: demand billing I am not a billing person(I am a MDS coordinator) but I have a question. A resident was discharged from Medicare due to not progressing in therapy. At time of discharge there were no other skilling factors to proceed with medicare coverage. during the following 7 days of observation for this resident's sighnificant change off medicare ( we always do a SC when resident is discharged from medicare), he picked up enough doctor orders ( he also has DX of DM with 7 days injections, not a new dx) to place him into a clinically complex category..   Question: The family has requested a demand billing feeling that he should have continued with medicare coverage after d/c of therapy because they feel he declined because we stopped therapy. Does anyone agree that he should have been readmitted to medicare or will Medicare agree with  our decision?

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