How do I bill for a resident who was a MO HealthNet participant, went to the hospital, came back Medicare, went back to the hospital, and then came back to a semi-private room all in the same month?
Residents admitted to an inpatient hospital stay, return to the nursing home as Medicare days, back to the hospital, etc., are billed by adding detail lines. Detail lines must be in date order beginning with the oldest dates of service (DOS). Each segment appears on your remittance advice as a separate claim. In the example below, the resident was admitted to an inpatient hospital stay on November 4th. On November 8th, the resident was discharged from the hospital and returned to the nursing home as a Medicare day. A second inpatient hospital stay began November 19th and discharged on the 22nd with the resident returning to the nursing to a semi-private room.
Related Questions
- When a resident on Medicare Part A discharges to the hospital and is out past midnight then returns to skilled services, are a Form 3619 discharge and Form 3619 admission required?
- When admitting a new resident from the hospital on Medicare Part A, but applying for Medicaid co-insurance, do you have to complete Forms 3618 and 3619 admission?
- do emergency room stays count toward Medicare Part A three-day hospital stay?
