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Hospice and Skilled Nursing patients

CPS, C-EMR, PM

Last Post by Anonymous 1 second ago

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lkeith

(@lkeith)

Posts: 457

Honorable Member

Topic starter

We would like to find out how other clients on CPS 12 are handling situations like Hospice and skilled nursing charges. For example, for patients in a skilled nursing facility during a Mcare Part A stay, if they are seen here we can bill for the physician's charge for the visit to Medicare but if there is a procedure done such as an xray or lab, we have to bill those charges to the facility instead of to Medicare. Our previous PM system allowed us to set up "company accounts" and post charges to these accounts using the patient number of the patient. CPS doesn't allow this and we have been struggling with these, in most cases, the charges getting billed to Medicare instead of the skilled nursing facility.

Any suggestions or ideas on how you are handling these?

Thanks

Linda Keith

Posted : November 12, 2014 8:23 am

angelahunsberger

(@angelahunsberger)

Posts: 290

Reputable Member

Is there any way you could use the Alternate payor feature and have the ticket automatically split based on the Insurance and Procedure code? I can show you that feature if you are interested. It is typically used for DME billing but maybe it would work for your situation?

I'm curious to see how others will respond to your question as well.

Posted : November 18, 2014 5:57 am

lkeith

(@lkeith)

Posts: 457

Honorable Member

Topic starter

The problem is this wouldn't always be the case. This only applies to patient's who are in a skilled nursing facility for rehab only. So say they are in the SNF for 3 months and then are released, then at that point, the skilled nursing facility is no longer responsible. In our previous PM system, we would set up an account for the skilled nursing facility. Since we use EMR Link, when the offices would order lab/xray, they would be prompted with a question basically asking them if this was for a skilled nursing stay. If they answered yes, they would be prompted to enter the account number, which was in a dropdown list that they could choose from. When the charges were sent to billing, those charges would be billed to that account with the patient's ID number.

We have set up the skilled nursing facilities as insurance carriers in CPS, but we just haven't come up with a good way to alert the appropriate staff to get it billed correctly.

Posted : November 18, 2014 6:32 am

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