Medicare In-person review
Description
Collection
Title:
Medicare In-person review
Date:
1/2/2006
Text:
Hello All,
I'm looking for what I'm sure someone else would also like to know regarding consolidated billing and snf stays. Our facility delivered, billed, and received payment for an afo to a pt who was well over her 100 days; yet, she had bounced around between snf's and the hospital and back to another snf between the time of evaluation and delivery (a total of 10 days). Medicare decided to help themselves back to the payment. We have a review scheduled with a medicare person who called me to set up the interview, and whose primary question to me was what's a sniff? Puzzled, I finally figured out she was asking me what the acronym for a skilled nursing facility was (snf). Of course, realizing by now I'm in serious doo-doo because now I not only have to show my point of view in providing service to a pt on part-B, but I need to educate and prove to the investigator just what the rules from cms
are regarding part-a and part-b stays, how they're defined, and where the pt falls in this whole mess. I've spent the better part of two hours cursing the medlearn web-site just trying to find the definitions. I know it's out there. any help?
Much appreciated, and will post applicable and printable replies.
Michael S. Johnson CPO
OrthoPro of Twin Falls, Inc.
762 North College Road
Suite A
Twin Falls, ID 83301
ph: 208-733-0505
fax: 208-734-0766
I'm looking for what I'm sure someone else would also like to know regarding consolidated billing and snf stays. Our facility delivered, billed, and received payment for an afo to a pt who was well over her 100 days; yet, she had bounced around between snf's and the hospital and back to another snf between the time of evaluation and delivery (a total of 10 days). Medicare decided to help themselves back to the payment. We have a review scheduled with a medicare person who called me to set up the interview, and whose primary question to me was what's a sniff? Puzzled, I finally figured out she was asking me what the acronym for a skilled nursing facility was (snf). Of course, realizing by now I'm in serious doo-doo because now I not only have to show my point of view in providing service to a pt on part-B, but I need to educate and prove to the investigator just what the rules from cms
are regarding part-a and part-b stays, how they're defined, and where the pt falls in this whole mess. I've spent the better part of two hours cursing the medlearn web-site just trying to find the definitions. I know it's out there. any help?
Much appreciated, and will post applicable and printable replies.
Michael S. Johnson CPO
OrthoPro of Twin Falls, Inc.
762 North College Road
Suite A
Twin Falls, ID 83301
ph: 208-733-0505
fax: 208-734-0766
Citation
“Medicare In-person review,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/226012.
