Re: RUG rate for nursing coverage

[edart6]

Yes--the rate paid is the RUG rate into which the patient falls. Your software should display the RUG when the assessment is completed. If a "lower" RUG, that is what you bill and that is what you get paid. You will probably get a request for a Medical Review from your fiscal intermediary--but if everything is in order, this should be no problem.   On Fri, 16 Apr 2004 14:50:29 -0500 "Michelle Witges" <[EMAIL PROTECTED]> writes: I am sorry, I guess I wasn't very specific.  She was in a Med A bed, after qualifying hospital stay, for therapy and wound care.  Therapy was d/c'd and wound healed but she was still having problems with labs PT/INR.  Physician did not visit he just made order changes along with labs.  There is adequate documentation for need of skilled service.  My question is at what rate would they pay?  I have a list of RUG's and dollar amounts but her assessment did not RUG out in the top 26.  If Medicare agrees that she still needed skilled service due to monitoring/assessment, what rate will they pay?  The rate that is assigned to the lower RUG's or what? Michelle   ----- Original Message ----- From: Ann Schoeny To: [EMAIL PROTECTED] Sent: Friday, April 16, 2004 11:14 AM Subject: RE: RUG rate for nursing coverage You have multiple order changes, but do you have M.D. visits? Did this person have a 3 day hospital stay, are they receiving therapy? Just being started on Coumadin would not necessarily place them in a "medicare"RUG   ann m schoeny crnac sem haven nursing and rehab 225 cleveland ave. milford, ohio 45150 (513) 248-1270 -----Original Message----- From: Michelle Witges [mailto:[EMAIL PROTECTED] Sent: Friday, April 16, 2004 11:53 AM To: [EMAIL PROTECTED] Subject: RUG rate for nursing coverage We had a resident who was started on Coumadin and having PT/INR done every other day with multiple med changes.  When the RUG was calculated it was not in the top 26 RUGs.  What rate would medicare pay in a sitution?  Michelle   This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If this message contains protected health information (PHI), it should not be forwarded to any other recipient without the authorization of the original sender and should be encrypted when possible.  If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the email address or telephone number above and delete this email from your computer.   Thank You.   Michelle Witges   To admit you were wrong is to declare you are wiser now than before. --Unknown

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