Re: critical access hospital

[Guest guest]

What people confuse is they believe that those who

submit claims to a fiscal intermediary (FI) are

billing Part A services. Fiscal intermediaries

reimburse for services covered under both Part A and

Part B Medicare benefits. Part A services include

inpatient acute care services, IRF services, and SNF

Part A services.

FI's also reimburse for services covered under

Medicare Part B benefits. This would include

outpatient therapy services. CMS is phasing in

Medicare Administrative Contractors (MAC's) over the

next 3 years and the MAC's will replace the Medicare

carrier and FI in each state and reimburse for all

services in that state except home health and DME.

Rick Gawenda, PT

President, Section on Health Policy & Administration

APTA

--- michael butterfield

wrote:

>

>

> Hello everyone,

> I am a new Director at a

> small rural critcal access hosptial. I was updating

> our charge master and updating some of the untimed

> charges.

> I got a call from my

> billing director and she asked why I had forwarded

> the changes, I told her I was getting our oupt

> billing compliant with Medicare part B. She then

> told me that she bills medicare part A for all inpt

> and OUTPT charges. I didn't realize that CAH's have

> the option of billing medicare A for oupt physical

> therapy services.

>

> Is it true that critical access hospitals can bill

> medicare A for outpt services as well?

>

> thanks for any help offered,

>

> Mike Butterfield OT

> Penobscot Valley Hospital

> Lincoln,ME

>

>

>

> ---------------------------------

> Be a better friend, newshound, and know-it-all with

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>

> [Non-text portions of this message have been

> removed]

>

>

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[Guest guest]

Mike,

Your billing director is correct. This is how we do it as well. All

out-pt. charges go to part A due to our Critical Access Standing. Don't

ask me why but, this is how CMS decided to handle it.

Hope this helps! Good Day!

Chad W. Yoakam, MS, PT

Manager of Rehabilitation Services

Livingston HealthCare Orthopedic and Rehabilitation Institute

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of michael butterfield

Sent: Monday, January 14, 2008 12:53 PM

To: PTManager

Subject: critical access hospital

Hello everyone,

I am a new Director at a small rural critcal access hosptial. I was

updating our charge master and updating some of the untimed charges.

I got a call from my billing director and she asked why I had forwarded

the changes, I told her I was getting our oupt billing compliant with

Medicare part B. She then told me that she bills medicare part A for all

inpt and OUTPT charges. I didn't realize that CAH's have the option of

billing medicare A for oupt physical therapy services.

Is it true that critical access hospitals can bill medicare A for outpt

services as well?

thanks for any help offered,

Mike Butterfield OT

Penobscot Valley Hospital

Lincoln,ME

---------------------------------

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it now.

[Guest guest]

Mike,

Critical Access Hospitals are cost reimbursed for all rehab services.? That

includes inpatient and outpatient.? Cost reimbursement was the pre-1997 way of

paying for therapy services in most settings.? Therefore for each outpatient

therapy?service performed, ?the CAH gets an interim rate during the year based

on the previous year's cost settlement.? At the end of the year the hospital

submits all of its costs and all of its payments and adjusts the next year's

interim rate.? It may be higher (usually) or lower (not often) than the

physician's fee schedule. That's why your billing department doesn't care about

the fee schedule.

Lynn Janssen

President

Premier Health Associates, Inc.

West Des Moines, IA 50265

, ext. 222

critical access hospital

Hello everyone,

I am a new Director at a small rural critcal access hosptial. I was

updating our charge master and updating some of the untimed charges.

I got a call from my billing director and she asked why I had forwarded

the changes, I told her I was getting our oupt billing compliant with

Medicare part B. She then told me that she bills medicare part A for all

inpt and OUTPT charges. I didn't realize that CAH's have the option of

billing medicare A for oupt physical therapy services.

Is it true that critical access hospitals can bill medicare A for outpt

services as well?

thanks for any help offered,

Mike Butterfield OT

Penobscot Valley Hospital

Lincoln,ME

---------------------------------

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try

it now.

[Guest guest]

Our hospital recently received Critical Access Hospital designation.

As outpatient PT services now are billed to Medicare A, does anyone

know if there are the differences in practice

management/documentation?

Larson, MPT

>

>

>

> Hello everyone,

> I am a new Director at a small rural

critcal access hosptial. I was updating our charge master and

updating some of the untimed charges.

> I got a call from my billing director and

she asked why I had forwarded the changes, I told her I was getting

our oupt billing compliant with Medicare part B. She then told me

that she bills medicare part A for all inpt and OUTPT charges. I

didn't realize that CAH's have the option of billing medicare A for

oupt physical therapy services.

>

> Is it true that critical access hospitals can bill medicare A for

outpt services as well?

>

> thanks for any help offered,

>

> Mike Butterfield OT

> Penobscot Valley Hospital

> Lincoln,ME

>

>

>

> ---------------------------------

> Be a better friend, newshound, and know-it-all with Yahoo! Mobile.

Try it now.

>

>

[Guest guest]

,

CAH out-patient rehab practice management and documentation are still

the same as MC part B. Your billing department submits everything to

the CMS contractor which may be in the Part A " dept " but, everything is

different in terms of reimbursement which is on a cost basis rather than

the fee schedule. Make sure to follow Part B rules and regs for

out-patient services!

Hope this helps. I'd be happy to help if you have further questions as

we are a CAH.

Chad W. Yoakam, MS, PT

Manager of Rehabilitation Services

Livingston HealthCare Orthopedic and Rehabilitation Institute

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Larry Larson

Sent: Saturday, January 19, 2008 7:23 PM

To: PTManager

Subject: Re: critical access hospital

Our hospital recently received Critical Access Hospital designation.

As outpatient PT services now are billed to Medicare A, does anyone

know if there are the differences in practice

management/documentation?

Larson, MPT

>

>

>

> Hello everyone,

> I am a new Director at a small rural

critcal access hosptial. I was updating our charge master and

updating some of the untimed charges.

> I got a call from my billing director and

she asked why I had forwarded the changes, I told her I was getting

our oupt billing compliant with Medicare part B. She then told me

that she bills medicare part A for all inpt and OUTPT charges. I

didn't realize that CAH's have the option of billing medicare A for

oupt physical therapy services.

>

> Is it true that critical access hospitals can bill medicare A for

outpt services as well?

>

> thanks for any help offered,

>

> Mike Butterfield OT

> Penobscot Valley Hospital

> Lincoln,ME

>

>

>

> ---------------------------------

> Be a better friend, newshound, and know-it-all with Yahoo! Mobile.

Try it now.

>

>