RE: [MEDITECH-L] Long term care certified stays

[Bodnar-Anderson, Cindy]

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Sharon,

 

In B/AR, Procs Account, Edit Insurances, you'll see a screen somewhat like this:

Insurance  1 - A10                    Name      AMERICARE PROTECTION

                                                Address   PO BOX 10

Collector  FINCO 7                 Address 2

Biller     CATCH                      City      DES MOINES

                                                State     IA           ZIP    50301

                                                Phone     800-641-0366

Deductible $                             E-mail

Coinsurance $                                            Non Covered Days

Ins Copay $                                              From            Thru

Non-Cov Priv Rm $

Release Info                   Assign Benefits

Remark

 

For EACH Insurance, enter the Non-Covered Days.  With this process, don't mess with the order of insurance.... leave Medicare primary, and B/AR will know that all charges during these non-covered days will pass down to the next insurance...

 

 

So if Medicare covered the first 60 days, and then exhausted benefits, you would place day 61 thru end in the from thru non-covered days.

 

Same for EACH Insurance.

 

Once you test this process, you will see that B/AR can handle these non-covered days...

 

Hope this helps,

Cindy Bodnar-Anderson

IS, Senior Programmer/Analyst

Regional Health

Rapid City SD  57701

 

-----Original Message-----
From: Sharon Ott [mailto:[EMAIL PROTECTED]
Sent: Friday, July 14, 2006 6:14 AM
To: meditech-l@MTUsers.com
Subject: [MEDITECH-L] Long term care certified stays

Question for L users

 

One of our facilities have long term patients and we have them admitted during a fical year on one account number, and at the end of the fiscal year discharge them and get them a new number.  The problem the finance area is having is in reporting of when an account has to be changed from being medicare primary to medicaid primary or sp primary due to certification approval.  Please see if example below.

 

Question for you or any MEDITECH facilities with this related issue.

Do you know of any reporting in BAR that might handle the following situation?

Long term care patients that certified stays may change from MEDICARE, to
MEDICAID to SP during that years confinement.

This means that a single account number might go from having Medicaid the
primary payor, toMedicare being the primary payor, and back to Medicaid. While
the claim form system can sort of handle this, the other Meditech reporting
elements apparently can't.  While working on the budget, I have to be able to
separate the charges up between the charges covered by
Medicare (MCRLTC), Medicaid (MCDLTC), and patient responsibility (SP - when
neither Medicare nor Medicaid is the primary payor) and the payments/discounts
relating to those charges.

I've not been able to get reports that keep the primary payor/insurance group
status that was in place when the charges were incurred, so I'm looking for
options. 

Any advice on how to handle this type of situation?

If anyone has any type of reporting that they are currently using in this type of situation, would you be willing to share that information with us.

 

Thanks

 

Sharon Ott

Analyst

DCH Health System

205.343.8319

[EMAIL PROTECTED]

 

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