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Hi,
Faye have you heard when the New Medicare Letters
are going to be made available from the Empire Medicare intermediary?? Just
like previously have heard about them, But I haven't seen them yet.
Thanks
Stephanie
STATEMENT OF CONFIDENTIALITY: The information contained in this
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exclusive use of the addressee(s) and may contain confidential or privileged
information. If you are not the intended recipient, please notify Stephanie
Deon immediately at [EMAIL PROTECTED] and
destroy all copies of this message and any attachments. Thank you for your
cooperation
----- Original Message -----
Sent: Monday, February 02, 2004 9:52
AM
Subject: Re: demand billing
What is an ABN letter?
----- Original Message -----
Sent: Monday, February 02, 2004 9:43
AM
Subject: RE: demand billing
I would not change
my decision just because you will get a category. For multiple reasons
such as condition is chronic but stable, insulin qd is not a skillable
service your intermediary may agree with your decision. If you tell
someone Medicare will pay and they don�t you are financially liable and will
sustain a loss. However, this is why we do the next appropriate MDS on
everyone we cut ( off rehab do the OMRA and sometimes depending on how much
time it covers the next regular PPS and if not rehab the next
regularly scheduled PPS assessment). We submit them but use the RUGS
category on our demand bill so if by chance the FI disagrees with us we get
reimbursed at the correct rate. We do not get many of our decisions
overturned but when we do the loss by accepting default rate is unacceptable
to our administration. It is a little extra work but worth it in the
end. Demand bills are the reason I am so excited about the new ABN
letters. The old ones are not clear and I do not believe people really
understand what they are checking. The new ones are much clearer and I
hope will cut down on Demand bills. I don�t begrudge anyone their
rights but they are a pain.
-----Original
Message-----
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ann Schoeny
Sent: Monday, February 02, 2004 8:03
AM
To:
[EMAIL PROTECTED]
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.
-----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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