We do an OMRA as we are taking resident's off Medicare for this very reason. That MDS will RUG the resident and you are then prepared not only with more facts for the resident/family but if they decide to demand bill you are prepared. (We lost a claim due to this issue a long time ago and feel it is worth the extra effort.) ----- Original Message ----- From: Delores Nein Sent: Friday, February 13, 2004 7:54 AM To: [EMAIL PROTECTED] Cc: Anne Burrows; Barbara Feege; Teresa Evans Subject: Demand bill/continuation of PPS schedule Question. We occasionally have patients who are transferred from our
skilled unit to our nursing facility unit after no longer qualifing for
skilled services. We often do not know if the families want a demand
bill. Our billing office is stating that they need an MDS assessment
8-10 days after the denial letter is sent to correctly bill for the
demand bill period of time, eventhough we do continue the regular PPS
cycle. Is it correct to continue on the medicare PPS cycle taking into
account the possible need for an OMRA assessment if therapy ends or as
the billing office wants us to do, an OMRA even if therapy might
continue at a less than skilled need? What do you do?
Thanks.
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