No by putting them back on the pps cycle, that means you should have never cut them in 
the first place. What would you be skilling them for now? 

>>> [EMAIL PROTECTED] 04/15/04 08:29AM >>>
Thanks for your response...I know I do not have to restart the PPS cycle.  But do I 
have to put the person back on the PPS cycle.  Example....We cut the resident on day 
14.  It is now day 75 of their admission.  Do I do PPS assessments for the 25days they 
have left within the benefit period.  Or are you saying I do not have to do anymore 
PPS assessments.  Am I explaining this well??  As it stands now, if someone requests a 
demand bill we keep them on PPS until we get the decision regarding the demand bill.  
How should the billing department bill for this person?  FI told them they are to bill 
at the default rate from the cut date to current date.


Faith Palermo <[EMAIL PROTECTED]> wrote: No you don't start the pps cycle over again. 
A demand bill just means the family is not agreeing with your facilities decision to 
cut the resident. The demand bill along with your facilities documentation of why you 
cut the resident needs to be sent to your FI then Medicare reviews the information and 
may ask for ADR ( additional documention request). And they will let you know if you 
cut the resident too early or if it was appropriate. If they agree with the family 
they may reduce payment or not pay at all for the time resident was skilled, but you 
don't need to restart the pps cycle.

>>> [EMAIL PROTECTED] 04/15/04 07:46AM >>>
Resident was discharged from MedA when therapy was cut and there was no other skilled 
need. Denial letter was sent to family certified mail return receipt. No response to 
denial letter. As per our denial letter if you do not respond within 14days days we 
assume you do not want a demand bill. Now, 2 months later, the family is requesting a 
demand bill. Do I pick up where she left off?? There is no 30day or 60day assessment 
and now it would be time for her 90day. Do I start with the current date as the ARD 
and code it as a 30day or 90day? Thanks for any help!






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The Case Mix Discussion Group is a free service of the
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    For more info visit us at http://www.aanac.org
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