Long-Term Care

BALTC Q&A

Billing Alert for Long-Term Care, September 1, 2010

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A. The timing was perfect for this scenario. The reason Medicare denied your claim is because the Medicare qualifying hospital stay dates are in the wrong month. Based on the Medicare regulations, the hospital discharge date must have occurred on or after the first day of the month in which the resident turned 65. In this case, the hospital stay dates were May 18–23, and the resident was not qualified for Medicare Part A until June 1.

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.

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