ip hosp

--001a11362b7ea827090539bbb4cd
Content-Type: text/plain; charset=UTF-8

We provided a medicare patient an elbow rom brace while at a rehab. Turns
out this rehab is considered an in-patient hospital and denied our claim to
them stating they don't pay for supplies. I know medicare says we cannot
give dme to an individual who is in-patient unless they are being
discharged within the next two days. Is there any recourse in this
situation or are we out a brace?

Kara L. Andrews, R.M.A.
Practice Manager
Gynecology of Venice, P.L.
Orthopaedic Center of Venice, P.L.
241 Nokomis Ave. S., Ste. A-B
Venice, FL 34285
941-485-9941/941-485-3302

Comments

  • edited May 2017
    I’m not seeing any way to bill compliantly on the date dispensed.



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219-0409

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



    Since 1996, Celebrating 20 years of Service to Physicians



  • edited May 2017
    If the physicians office supplied the brace when the pt was considered IP the office should bill the facility for the cost of the brace which then becomes part of the facility bill.

  • edited May 2017
    You should bill the rehab.

    Marie Popkin, CPC
    Coding,Consulting & Compliance


  • edited May 2017
    The rehab has the right to reject your request to be reimbursed for a resource you chose on your own, without going through their vendor.



    Although I agree to the option to bill them for it, don’t be surprised if they deny you reimbursement because their vendor wasn’t used and you did not clear the purchase and dispense through them prior to giving it to the patient.



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219-0409

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



  • edited May 2017
    Definitely agree but it's your only recourse. I would contact the Admin if your physician intends to bring supplies in, we had a signed agreement from our rehab that they would reimburse us.

    Marie Popkin, CPC
    Coding,Consulting & Compliance


    \
  • Okay, thank you.

    Kara L. Andrews, R.M.A.
    Practice Manager
    Gynecology of Venice, P.L.
    Orthopaedic Center of Venice, P.L.
    241 Nokomis Ave. S., Ste. A-B
    Venice, FL 34285
    941-485-9941/941-485-3302

Sign In or Register to comment.