Wiki Medicaid hospice modifier

wentzks

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Help!! We saw a patient in the hospital as an infectious disease consult. We billed Medicaid and it denied stating patient was in a hospice segment. How do we get this paid? What if the patient does not have Medicare? Is that even possible?
 
reply to hospice care.

When a patient is transferred from regular medical care to Hospice care and the patient is Medicare eligible. Then you would bill all charges to Medicare. You should be able to contact Medicaid and ask for the Medicare ID number since they are saying the patient has Medicare. Or you may be able to verify Hospice eligible on the Medicare website. If the patient is eligible you will need to bill all charges to Medicare and add a GV or GW modifier to the charges depending on if the charges are hospice related or not. I hope this helps. If the patient has a Medicare HMO (replacement plan) when a patient is in hospice you would not longer bill the HMO. all charges go to regular Medicare.
I hope this helps.
 
What do you do if Medicare bill comes back with patient responsibility(ie: ded or coinsurance)?
 
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