Master the rehab workaround
Billing Alert for Long-Term Care, July 1, 2009
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.
When a resident’s therapy services are decreased or discontinued, but there are still payment days left under the rehab resource utilization group (RUG), a SNF biller may have to do a rehab workaround to prevent the claim from rejecting.
The Medicare claims processing system includes edits that will reject claims if the therapy services do not meet the criteria for the rehab RUG being billed.
“A rehab workaround bypasses the Medicare edits by putting the therapy services on the claim with a charge of one penny,” says Lee A. Heinbaugh, president of The Heinbaugh Group, a long-term care consulting company in Lakewood, OH. “Basically, it tricks the system into thinking that the correct amounts of therapy disciplines are included so the claim will process correctly.”
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.
Related Products
-
PPS Alert for Long-Term Care
Looking for a tool to make your job easier? PPS Alert for Long-Term Care, exclusively for the RN or MDS coordinator, is your...
-
CNA Training Advisor: Lesson Plans for Busy Staff Trainers
Finally-a staff training program that really works!
-
Coding and Billing for Outpatient Rehab Made Easy:
Take the confusion out of coding and billing for outpatient rehab and ensure you receive accurate reimbursement for the...
-
Coding and Billing for Medicare Part B Therapy Services:
This 90-minute audioconference offers advice to avoid coding pitfalls and ensure your rehab facility's financial health.
-
Billing Alert for Long-Term Care
It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility...
Most Popular
- Articles
-
- Q/A: Billing telemetry daily monitoring
- Credentialing monthly: What is the role of the credentials committee in addressing unprofessional conduct?
- 2010 ICD-9 code updates now available online
- Master modifiers to ensure accurate reimbursement
- Radiologist indicted for fraudulently signing reports
- National Quality Forum creates standardized set of data for electronic health records
- H1N1 hits Maine facility
- New report reveals $47 billion in Medicare fraud
- Understand the H1N1 Flu and how to code it
- Don’t be scared into silence: Affiliation letter safeguards allow you to disclose more
- E-mailed
-
- Q/A: Billing telemetry daily monitoring
- Credentialing monthly: What is the role of the credentials committee in addressing unprofessional conduct?
- Radiologist indicted for fraudulently signing reports
- Revised MS.1.20 'huge improvement', out for comment again
- Briefings on Outpatient Rehab Reimbursement and Regulations, December 2009
- New report reveals $47 billion in Medicare fraud
- Press Ganey report: Patient satisfaction increasing across the country
- Residency Program Alert, December 2009
- CMW News: Palliative care programs save hospitals money
- Briefings on The Joint Commission, June 2009
- Searched