Applies to: Doctors, Assistants, Clinic Supervisors, Billing, Front Office
Please see the information below. It shows where the "Residence" listing is noted under the "Social History" Section in Medflow. (This is where you would note if the patient resides in a private residence vs. a nursing home, an assisted living facility or a rehabilitation facility).
This is of great importance as due to the "consolidated billing" rules, if we do not determine if a patient resides in a nursing home, an assisted living facility or a rehabilitation facility, prior to initiating care and we do not contact that facility first to authorize payment we will not receive payment, even if the patient has a valid Medicare card. (If payment is made, it will likely be recouped within three months).
All Assistants must double check this at all visits - we cannot assume that by looking at someone and seeing that they appear relatively healthy that residency in one of these types of facilities is not a possibility. The consolidated billing issue becomes a factor even for very short/temporary stays.
If you find that a patient resides in such a facility, immediately contact the Billing Lead so that she may obtain authorization prior to initiating care. If you have difficulty getting ahold of someone in billing me and I will facilitate this .
Sent: Thursday, April 4, 2013 4:58 PM
Subject: RE: Nursing Home/Rehab/Assisted Living Tab in Allscripts
Please see the updated attachment. This shows where in Medflow this information will be entered and accessed.
Unfortunately, we are unable to edit section headings in ROS, but I was able to add a “Residence” section in Social History (right next door to ROS and Family History J )
Please see the information below. It shows where the "Residence" listing is noted under the "Social History" Section in Medflow. (This is where you would note if the patient resides in a private residence vs. a nursing home, an assisted living facility or a rehabilitation facility).
This is of great importance as due to the "consolidated billing" rules, if we do not determine if a patient resides in a nursing home, an assisted living facility or a rehabilitation facility, prior to initiating care and we do not contact that facility first to authorize payment we will not receive payment, even if the patient has a valid Medicare card. (If payment is made, it will likely be recouped within three months).
All Assistants must double check this at all visits - we cannot assume that by looking at someone and seeing that they appear relatively healthy that residency in one of these types of facilities is not a possibility. The consolidated billing issue becomes a factor even for very short/temporary stays.
If you find that a patient resides in such a facility, immediately contact the Billing Lead so that she may obtain authorization prior to initiating care. If you have difficulty getting ahold of someone in billing me and I will facilitate this .
Sent: Thursday, April 4, 2013 4:58 PM
Subject: RE: Nursing Home/Rehab/Assisted Living Tab in Allscripts
Please see the updated attachment. This shows where in Medflow this information will be entered and accessed.
Unfortunately, we are unable to edit section headings in ROS, but I was able to add a “Residence” section in Social History (right next door to ROS and Family History J )
| policy_protocol_nursing_home_rehab_assisted_living_in_allscripts_04052013.docx |