what would the skilled service be????? >>> [EMAIL PROTECTED] 04/15/04 09:10AM >>> Actually I would disagree. I would resume the PPS schedule now to end the default. If it is day 75, then do a 60 day assessment (late). If the FI decides that they should have been skilled this entire time, you would have to bill default for the days without the assessment then bill whatever RUG score you obtain from this late 60 day.
ron -----Original Message----- From: Faith Palermo [mailto:[EMAIL PROTECTED] Sent: Thursday, April 15, 2004 8:01 AM To: [EMAIL PROTECTED] Subject: Re: demand bill..Need help! 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! --------------------------------- Do you Yahoo!? Yahoo! Tax Center - File online by April 15th NOTICE: This confidential message/attachment contains information intended for a specific individual(s) purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete this /---------------------------------------------------------- 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 -----------------------------------------------------------/ --------------------------------- Do you Yahoo!? Yahoo! Tax Center - File online by April 15th NOTICE: This confidential message/attachment contains information intended for a specific individual(s) purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete this /---------------------------------------------------------- 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 -----------------------------------------------------------/ NOTICE: This confidential message/attachment contains information intended for a specific individual(s) purpose. Any inappropriate use, distribution or copying is strictly prohibited. If received in error, notify the sender and immediately delete this /---------------------------------------------------------- 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 -----------------------------------------------------------/
