No payment bills
Compliance Monitor, March 3, 2006
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Q: Can you give me some information regarding the implementation of "no payment bill?" Medicare is using the "no payment bills" to track the benefit period.
A: The CMS Carrier Manual under the General Section for Eligibility and Entitlement, Chapter 3, Section 10.4.1 and 10.4.2 discusses the "beginning and end period" of a patient services at a hospital and/or SNF. Further in that same Section 10.4.4 discusses several "assumptions" dealing with the determination of "inpatient" regarding SNF patients. CMS in that section specifically speaks about "no payment claims" and requirement to submit those claims in order to make the determination/assumption of the status of the patient and what if any services are payable under Medicare.
I believe those sections will be of assistance regarding the no payment claim and the importance of submitting those claims when required in order to establish the patient status.
Thanks to Rick Oliver JD, CHCO, CPC, MT(ASCP) of Healthcare Compliance Consultants for Small Providers (HCCSP) for answering this question.
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