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There's only one problem, the resident has since
expired.
----- Original Message -----
Sent: Monday, February 02, 2004 8:03
AM
Subject: RE: demand billing
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.
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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