You need to work with your Fiscal Intermediary on this one. It should be possible to
use the admission assessment. Since it was done early, you would need to take default
for the number of days it was done early, in this case 1 day. You would get paid
default for days 1-14 since no 5 day, then default for day 15 because of the one day
early, then paid at the RUG of the admission assessment until day 30. Some FIs are
more accommodating than others. IF the first person you call at the FI is not
helpful, ask to ask for a supervisor, preferably a nurse who works in their Long-term
care division. Good luck. this is another reason why many of us do Medicare
assessments for residents on insurance who also have Medicare.
-----Original Message-----
From: [EMAIL PROTECTED]
Sent: Mar 25, 2004 10:25 AM
To: [EMAIL PROTECTED]
Subject: Missed medicare assessments/Rena
Our business office justed call to see what I could do[if anything]Patient admitted as
managed care Aug 19th ,dc/d Sept 30th.Insur company won't pay,because medicare was
primary.He had 1 MDS done which was ref on day 10,so I can't use that at all as a
14day.Can I do anything to not get default rate for his entire stay.I remember someone
asking simular question,but didn't pay attention to answer,"AS THIS WOULD NEVER HAPPEN
IN MY FACILITY",ha,ha.Any advice would be appreciated.
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
