We recently (actually a year ago) had a resident who was denied Medicare for
about 22 days - their (FI) reason was that the Physical therapy was not
medically necessary. My question is we have not received any payment for that period -
we are appealing, but what happens now - if they still deny her - can she still be
covered under another RUG score. Should we
have done another MDS at the time of the denial - but that does not make sense
to me? Does any body have any
experience with this? Thank you in advance.
Holly QI in CT
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