In this sample, the resident appears to have no remaining Medicare A days as indicated by the 0 in both the SNF Full Days and SNF Co Days. HOWEVER, notice the date of last billing! Medicare had not been billed for this resident since 2007. At this point, the facility needs to verify that the resident has had at least 60 Wellness Days since the last time on Medicare, and then proceed to examine the resident’s history over the last 90 days (at least) to determine which day of Medicare we might be starting on. Once Medicare is billed again, the system will reset showing the new benefit period and available days. Sample 3 The screening indicates an effective date for Part B benefits. Benefits are then shown for Physical Therapy and Speech, which are lumped together in one category, and for Occupational Therapy. For Medicare Part B, the amount shown in the blanks is the amount of therapy dollars billed for the resident as of January 1st 2013. When you see a screening with $0.00 amounts shown, it means that no therapy dollars have been billed to Medicare. However, this only indicates the billing that has been processed there could still be billing out there that is not – reflected here! Sample 4 This screening sample indicates that the resident had $291.69 worth of physical therapy and/or speech therapy charges billed to Medicare B during the year, and $130.29 worth of occupational therapy billed during the year. Therapy will want to review these amounts frequently to monitor when the resident reaches the Cap” at $1920 and when a resident would reach the “Therapy Threshold” of $3700 for the year. At times we do have reason to bill therapy past the “Therapy
In this sample, the resident appears to have no remaining Medicare A days as indicated by the 0 in both the SNF Full Days and SNF Co Days. HOWEVER, notice the date of last billing! Medicare had not been billed for this resident since 2007. At this point, the facility needs to verify that the resident has had at least 60 Wellness Days since the last time on Medicare, and then proceed to examine the resident’s history over the last 90 days (at least) to determine which day of Medicare we might be starting on. Once Medicare is billed again, the system will reset showing the new benefit period and available days. Sample 3 The screening indicates an effective date for Part B benefits. Benefits are then shown for Physical Therapy and Speech, which are lumped together in one category, and for Occupational Therapy. For Medicare Part B, the amount shown in the blanks is the amount of therapy dollars billed for the resident as of January 1st 2013. When you see a screening with $0.00 amounts shown, it means that no therapy dollars have been billed to Medicare. However, this only indicates the billing that has been processed – there could still be billing out there that is not reflected here! Sample 4 This screening sample indicates that the resident had $291.69 worth of physical therapy and/or speech therapy charges billed to Medicare B during the year, and $130.29 worth of occupational therapy billed during the year. Therapy will want to review these amounts frequently to monitor when the resident reaches the “Therapy Cap” at $1920 and when a resident would reach the “Therapy Threshold” of $3700 for the year. At times we do have reason to bill therapy past the