No OMRA should have been done....
You combine the 2 months UB's....if the previous month has been paid your biller will need to do an adjustment bill to cover both months, example from date 1/1/04 thru date 2/29/04, and it will encompass all ancillaries, etc for both months.
By chance if the prior month was your year-end you cannot span months...in that case you add OT with charge of $1.00 then in the remarks area on the UB note why the additional therapy and $1.00 were added to the claim....I don't remember the exact wording you can call your FI and check on that.
In calling the FI I would be sure and get a supervisor as the help desk is often way off base on some of their answers. Just last week one of our bookkeepers was told by the FI helpdesk that if a person exhausted their beneifts and remained in the nursing home they would NEVER under any circumstances get a new benefit period!
[EMAIL PROTECTED] wrote:
[EMAIL PROTECTED] wrote:
We have a resident that received 2 therapies thru the ARD of the 30 day assessment, and placed in the RUB category. The next day (after the ARD) the resident Dc'd from OT.
When the bill was sent in they denied payment based on the fact that the resident was in a RUB category "more than 10 days, without two therapies." Should we have done an OMRA to lower the category between 8-10 days after OT dropped? And now what do we do, bill at the RUB for 10 days and then default rate until the next assessment b/c we did not do an OMRA?
Thanks
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