Re: Refresh my memory

[Rnlncoh]

In a message dated 1/15/04 5:00:50 PM Eastern Standard Time, [EMAIL PROTECTED] writes: Second question is about a mess up.  Did not D/C from skilled in the chart after 100 days.  Reviewed today and realized we were over, so many in and out of the hospital , 5 day , d/c prior to admit, admission and 5 day,  14 day d/c and so on and we messed up.  We have not billed for this, but what needs to happen now? Last assessment was needed, so that is ok.   My biggest concern is she is on Vancomycin and she returns to medical assistance for payment.    I am worried Vanc. is not on the preferred list.  What do I do about the pre authorization form that probably needs filled out?  I have never done this before and I am just a mess.  My biller keeps the count and I used to also, I guess I will go back to marking off the days as I did before.  Any suggestions to fix the mess up?    Thanks in advance for any info.

As long as you haven't billed for over 100 days, you are ok in that area.  Determine the last covered day, bill appropriately, and continue the OBRA schedule.  Was an OMRA needed?  I don't know how far past you are but you may be able to still do one if needed.  As for the pre-auth, fill it in and send it in.  You can send a letter with it explaining the confusion over the dates.  They will say yes or no.  You can appeal a no.  You also can check to see if a less expensive ATB can be used.  Vanco is so common now that it is pretty much on everyone's pharmacy list.  And document in a nursing note when the last covered day was and that you have applied for the pre auth for the vanco, awaiting answer.  That is about all you can do, from what I can see.  Mistakes happen.  That is how we all learn!    Sherri