MDS Alert
WHAT DO YOU THINK? How Do Medicare Advantage Plans Handle Consolidated Billing?
Published on Wed Nov 04, 2009
Question: Do Medicare Advantage plans follow the same consolidated billing rules for a resident going out for an X-ray where the SNF is only responsible for the technical component? Or since it's the Medicare Advantage program, do we have to pay both the technical and professional components for the X-ray? Answer: SNF consolidated billing only applies for fee-for-service for the original Medicare program. Managed care follows their own sets of rules. You have to check with them to see what those rules are. Source: SNF/LTC Open Door Forum Q&A Session, Oct. 15, 2009.
Other Articles in this issue of
MDS Alert
- QUALITY OF CARE:
Shore Up ADL Care Safety With 4 Pivotal Strategies
Don't overlook these triggers for revisiting how much help a resident needs. Envision this: A [...] - Workplace Safety:
Tap OSHA Guidelines, Other Recs to Prevent Ergonomic Injuries
Take advantage of the wealth of info available. Many nursing facilities are implementing patient handling [...] - MDS 3.0:
The Countdown Continues: CMS Hits Milestone for Achieving Oct. 1, 2010 Rollout
Find out what instructions to expect when. The final MDS 3.0 debuted on Oct. 29, [...] - STAFF TRAINING:
Prepare for MDS 3.0 Without Digging Into the Nitty Gritty
Here's what your facility can do now without having to backtrack later. Talk about frustrating: [...] - QUALITY IMPROVEMENT:
Tales of Two Care Plans Address Falls, Fear of Letting Go of a Lap Buddy
Creativity in individualizing care -- and persistence -- can pay off. If your facility has a resident [...] - MDS 3.0:
Check Out the Final Section G ADL Section - PAYMENT TRENDS:
Beware: Reports Indicate Hospitals Providing More Observation Stays
If you get a technical denial, look to Parts B and D to pay for [...] - CASE STUDY:
Looking for a More Surefire Way to Keep Physician Certs/Recerts on Track?
Hint: Try hard-to-ignore hot pink binders. If your SNF uses Medicare Part A certs/ recert [...] - WHAT DO YOU THINK? How Do Medicare Advantage Plans Handle Consolidated Billing?
Question: Do Medicare Advantage plans follow the same consolidated billing rules for a resident going [...] - WHAT DO YOU THINK? Do You Code a Bath Lift at G6d (Lifted Mechanically)?
Question: A resident requires a bath lift. Would staff code that at G6d ? Answer: [...] - MEDICARE:
Be Certain to Meet Medicare Part A SNF Certification/Recertification Requirements
Get the required info on time and know what to do if you don't. Failure [...] - MEDICATION SAFETY:
Crosscheck Antihypertensive Meds With These Conditions
Don't let failure to check the MAR end up marring your survey record. Anytime a [...] - Medicare:
Providers Can Find No Clear Reason for Reported Uptick in Hospital Observation Days
A new legislative provision could help reduce over-use of observation stays, says one expert. Anecdotal [...] - MDS & CLINICAL NEWS TO USE
The quality measures posted on Nursing Home Compare now reflect an average of three quarters' [...]
View All
