RE: RE: Regenerate Medicare days

[Guest guest]

Hello May,

The answer depends on how the SNF stay was being treated after the days ran

out. In order to obtain a new benefit period, the patient must have 60

consecutive days without a skilled level of care. The skilled level can

occur in a hospital or the SNF. If the patient remained in the facility in a

Certified bed and was still receiving a " skilled level of care " from

nursing, even though Med A is not paying for it, then they cannot be counted

towards the 60 days. If he was not, and was not admitted as an inpatient in

April, then the days start from the last paid for day by Medicare. 60 days

would be May 13th, so at that point, he would get the 100 covered benefit

days back.

The way to know is to see if the billing office is sending in a claim to

Medicare. If the patient is still considered " skilled " then monthly they

must generate a " claim " to Medicare, indicating that the patient is still at

a skilled level and so Medicare does not start the count towards a new

benefit period. Once the patient changes their status to a resident of the

non-skilled portion of the facility, the billing department would generate

the " discharge " and the counting would begin.

I hope that makes sense to you. What makes the skill is not the payment

source but the level of services required, so talk to your billing office.

ine

ine M. o, PT

Owner

Encompass Consulting & Education, LLC

8114 NW 100th Terrace, Tamarac, FL 33321-1259

We work hard to make sure you are " getting it right from the start " . Visit

our website at <http://www.encompassmedicare.com/>

www.encompassmedicare.com and see what we can do for you. While there sign

up for our free e-mail Newsletter " Medicare News and Rules for Therapists " .

We specialize in consulting services, seminars and customized education

services to providers of Medicare rehabilitation therapy and related

services.

NOTICE: This communication is intended only for the use of the individual or

entity to which it is addressed and may contain information that is

privileged, confidential and exempt from disclosure under applicable law. If

the reader of this communication is not the intended recipient or the

employee or agent responsible for delivering the communication, you are

hereby notified that any dissemination, distribution or copying of this

communication is strictly prohibited. If you have received this

communication in error, please notify me immediately by replying to this

email.

From: PTManager [mailto:PTManager ] On Behalf

Of may_pt75

Sent: Friday, June 03, 2011 9:32 PM

To: PTManager

Subject: RE: Regenerate Medicare days

Hello!

I need help regarding the situation below.

Example:

An 87 year old male patient was admitted to SNF as medicare.

> march 13, 2011 - exhausted medicare days

> april 19, 2011 - patient went to acute hospital for declogging of shunt,

came back to SNF the same day.

> may 28, 2011 - patient went to hospital for four days...

My question is, does this patient regenerates his medicare days when

readmitted to SNF?

I appreciate all your help

Respectfully yours,

May Almario

PT staff-california