The HHA needs to fix it claim to Medicare or possible bill Medicare to let
them know that his person is no longer under a HHA POC- until they do there
is not way for the SNF to bill.

Theresa Lang
Specialized Medical Services, Inc.
Milwaukee, WI



-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Chriss, Theresa M.
Sent: Tuesday, April 06, 2004 8:21 AM
To: AANAC Q&A (E-mail)
Subject: question regarding billing for outpatient


I don't know much about this, but here it goes!  We were told that before
our facility can bill for outpatient services, the patient needs to be
officially "closed out" by their home health agency.  Apparently what was
happening was that Medicare considered the patient to be open for 60 days
with home health.  When in fact, they were in home health 2 weeks, and then
to our facility for outpatient therapies.  I guess when we went to bill, we
were denied, because they were still in home health.  Does anyone know
anything about this and what procedures to follow to ensure proper payment??

Right now, we've had 2 denied.  So we are no longer accepting patients for
outpatient if they've been in home health.


THANKS
TERRI    :0)




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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
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