Long-Term Care

Late vs. missed assessments: The difference is money

Billing Alert for Long-Term Care, October 1, 2008

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The skilled nursing facility (SNF) PPS and consolidated billing final rule for fiscal year 2009 clarifies the difference between a late assessment and a missed assessment—a key concept when it comes to default billing, says Ronald A. Orth, RN, NHA, RAC-CT, CPC, owner and president of Milwaukee-based Clinical Reimbursement Solutions, LLC.

A late assessment is “an assessment that is still completed while the resident is under the Part A stay, but the assessment reference date [ARD] is not set within the appropriate assessment window,” Orth explains. “CMS will allow SNFs to complete a late assessment as long as the resident is still in the facility under Part A.”

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