By FBC Services.  Medicare General Information  Medicare A General Information ◦ NO-Pay and Benefit Exhaust Bills ◦ SNF Denial Information ◦ MSP Medicare.

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Presentation transcript:

By FBC Services

 Medicare General Information  Medicare A General Information ◦ NO-Pay and Benefit Exhaust Bills ◦ SNF Denial Information ◦ MSP Medicare Secondary Payer ◦ Assessments and OMRA’s  Medicare B General Information ◦ What’s Covered ◦ Bundling and Therapy Caps ◦ 59 and KX codes

 DDE Information ◦ Claims Correction ◦ CWF  Roster Billing  Questions and Answers

 The Medicare Program  Eligibility  Benefit Period

 No Pay and Benefit Exhaust Bills  SNF Denial Information  MSP Medicare Secondary Payer  Assessments and OMRA’s

 How and When to do a No-Pay Bill  Appropriate Codes  No-Pay Bill Vs. Demand Bills

 Denial on Admission  UR Denials  Denial Paragraphs  For CMS Denial Letters Go To The CMS site at andSNFDenialLetters.asp

 MSP Overview  When and How to Submit an MSP Claim

 ARD’s and Grace Days  OMRA’s  Assessment Schedule  Assessment Tracker

Medicare MDS Assessment Type Reason for Assessment (AA8b code) Assessment Reference Date Applicable Medicare Payment Days 5 day01Days 1 – 51 through day07Days 11 – 1415 through day02Days 21 – 2931 through day03Days 50 – 5961 through day04Days 80 – 8991 through 100

 What’s Covered  To Bundle or Not to Bundle  Therapy Caps  59 and KX codes  What to do when you’re out of space

 Menu’s  Claims Corrections and Adjustments  CWF  Roster Billing

 Claims-Special OC Codes  Return to History  Rejected Claims  Claim Change Codes

 How to Read the CWF  Insurance Codes

 FLU and PPV HCPCS  Rates  Format