Wiki Pts from a rehab hospital

[RebeccaB]

Hi everyone,

Our physicians have been seeing patients in the office (urology practice) that are being brought from the rehab facility (Rehab Hosp of WI) and Medicare has denied the claims
as services not payable. We have found out these pt's are considered as in patient when in this facility. Any ideas as to how we can get our claims paid ?

Thanks for any/all input

Thanks,
Rebecca
Urology Associates

 

[mitchellde]

You must use the POS of where the patient is registered. If they are registered as an inpatient at a rehab facility then you will use the POS for inpatient rehab not POS 11 even though service was rendered in the office setting. You will be reimbursed as though the provider saw the patient in the facility.

 

[RebeccaB]

Thanks for the info