We do the next scheduled PPS assessment adding an OMRA when appropriate. We schedule everything as though rehab was d/c but the resident stayed skilled. We do not do PPS assessments for the entire 100 day benefit period but we do enough so that we could provide appropriate RUGS categories for a minimum of 30 days if needed. My personal experience has been that even if my decision is overturned it is usually a matter of a few days. Only once did I have a decision overturned for a 30 day period and to be honest I never did quite understand their theory on that one.
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Delores Nein Sent: Friday, February 13, 2004 8:53 AM To: [EMAIL PROTECTED] Cc: Anne Burrows; Barbara Feege; Teresa Evans Subject: Demand bill/continuation of PPS schedule Question. We occasionally have patients who are transferred from our skilled unit to our nursing facility unit after no longer qualifing for skilled services. We often do not know if the families want a demand bill. Our billing office is stating that they need an MDS assessment 8-10 days after the denial letter is sent to correctly bill for the demand bill period of time, eventhough we do continue the regular PPS cycle. Is it correct to continue on the medicare PPS cycle taking into account the possible need for an OMRA assessment if therapy ends or as the billing office wants us to do, an OMRA even if therapy might continue at a less than skilled need? What do you do? Thanks. /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
