Sometimes you are trying to verify benefits / payer source on a referral and you’re working with a Medicare number that ends in a letter.  Here’s a quick cheat sheet on the meaning associated with that letter: Code Meaning A Primary claimant (wage earner), retired worker B Aged wife, age 62 or over B1 Aged husband, age 62 or over B2 Young wife, with a child in her care B3 Aged wife, age 62 or over, second...

This is a problem that comes up in nursing homes at times.  You have a nursing home resident that goes home in the middle of their 100-day Medicare benefit period.  They get home, have a decline, and need to come back to you.  If they need skilled services within 30 days of the discharge from your facility, you can accept them back under Part A without a new 3-midnight hospital stay. If they’ve stayed out of the skilled nursing...

Something interesting I’m finding in many facilities, and let me tell you, I’m a little upset over it.  Apparently, there are nursing home administrators out there that are telling their facilities that no resident can have mental health services while they’re on Medicare Part A.  What?  This is a terrible management decision.  If your administrator or your company is doing this, tell them I’m taking their keys...

I had a friend call me today with an interesting dilema.  She knows an administrator who is in bedlock.  What this means is the administrator has a building that is dually certified – Medicare & Medicaid – and has so many long term Medicaid and private pay residents that she has no beds to admit a Medicare resident.  That’s great, right?  A full house; every bed is full.  Not so fast.  The Medicaid rate is much,...

Many Nursing Home Administrators and Business Office Managers do not fully understand the concept of Medicare Reimbursable Bad Debt or realize the potential dollars they may be forfeiting.  I am going to try to break it down so that you can stop losing money and capitalize on an opportunity sitting right in front of you. Let’s set up a typical NH scenario: Resident Jane Doe fell at home and broke her hip.  She was admitted into the...