Fw: Medicare/Nursing Homes/private pay

Fw: Medicare/Nursing Homes/private pay

Michael P Madden

3/6/2002

Thanks to all who replied to my post (Questions below), I got a free
lunch on the bet,

The general consensus is that the NH/SNF is responsible to pay for the
required services, and that the family cannot opt to pick up the cost
if the NH/SNF refuse to order needed services. The NH/SNF cannot
refuse to provide the care was clear, weather my colleague will risk his
relationship with them is yet to be seen.

No one was able to give me chapter and verse of the regulation per
billing, DOS and delivery on custom fabricated items, though most felt
that delivery date/billing date/DOS should be the same...

Thanks to all who responded.

Mike M.


I am passing along a question for a colleague who is not on the list,
looking for clarification on two issue's:

#1 He has a patient in a nursing home who needs orthotic care. The
patient is in the Part A stay and the nursing home has refused (though
they will not use that word) to issue a PO or pay for the item that is
being requested. If this is the case can he bill the family, if they are
willing to pay. He was under the impression the nursing home could not
refuse, He is also concerned about offending the staff and losing the
referral source by pushing the issue?

any clarification would be appreciated...

#2 He was also looking for the specific Medicare regulation that states
that the DOS and delivery dates must be the same on custom O&P.

will pass responses along, and post the same.

Thanks in advance,

Mike M.


________________________________________________________________
GET INTERNET ACCESS FROM JUNO!
Juno offers FREE or PREMIUM Internet access for less!
Join Juno today! For your FREE software, visit:
<URL Redacted>.