RE: Missed medicare assessments/Rena

[Orth, Ron A]

Title: Re: Missed medicare assessments/Rena

You could probably use the assessment done on day 10 as your 14-day assessment even though it would be considered 1 day early.  Given that, you would take default for days 1-15, bill at the appropr. RUG for days 16-30.  If they were there longer than that and no other assessment was done then you would bill at the default for the remainder of their stay.

 

Ron

-----Original Message-----
From: Brenda L. Graham [mailto:[EMAIL PROTECTED]
Sent: Thursday, March 25, 2004 2:11 PM
To: [EMAIL PROTECTED]
Subject: RE: Missed medicare assessments/Rena

It would be paid at the default rate for entire stay because the MDS had an ARD of day 10 not days 5-8 or 11-14. Window of time was incorrect.

---

From: [EMAIL PROTECTED] on behalf of Michelle Witges
Sent: Thu 3/25/2004 3:05 PM
To: [EMAIL PROTECTED]
Subject: Re: Missed medicare assessments/Rena

I believe you will have to take default rate from day 1 until the admission
assessment was done, then you could use that RUG score up to day 30. which
would be 9-17--, then you would have to take default rate from the 18th
through the rest of his stay.  That is my understanding, I could be wrong.
Michelle

Original Message -----
From: <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Thursday, March 25, 2004 12:25 PM
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.
>
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/----------------------------------------------------------
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
-----------------------------------------------------------/