managed care and the mds
Register Today!-
This is a discussion on managed care and the mds in MDS Coordinator Information, part of Nursing Specialties ... Hey guys, I just started at a new facility, I have a question about how a managed care...
by michmommylala Jan 8Hey guys,
I just started at a new facility, I have a question about how a managed care assessment in put into your system...for example...in the past any skilled managed care resident, just rec'd an admission assessment then followed the OBRA schedule. This building does an admission assessment, federally req assessment then a 5 day with the same ARD but codes it as "not a federally req assess" then the 14 day and so on like a Med A patient, all not labeled as a federally req assessment.
I am very confused and wondered if anyone in PA is doing this. Other RNACs I know in PA are not. maybe Aetna has changed they way they are billing and want to use the patient RUG score...any help would be appreciated,
Print and share with friends and family.
Compliments of allnurses.com.
http://allnurses.com/showthread.php?t=806951©2013 allnurses.com INC. All Rights Reserved. -
-
Jan 8 by Ruas61In Minnesota here and some contracts call for this with. One needs to check the fine print with requirements per each plan. Humana can be very tough. -
Jan 9 by wbardelliThere is no fine print. An admission assessment is required for federal. You put it in just as an admission, you do not have to put in as admission 5 day and you do not do two seperate admission assessments. You then would continue as you were doing for 14 day, 30 day ect not federally required - Jan 9 by michmommylalathanks for the response...this particular building does it like this which I found odd... I don't want to buck the rules being new but this is how our corporate RNAC said to do it...oh well. Was just wondering
- Jan 9 by Ruas61Federal required MDS cannot be combined with insurance advantage plans. If the insurance company wishes the resident to have MDS done per PPS schedule you would do them but not submit them. As you have been doing so it seems. This would be in the fine print of the contract requirements for paymnt. If you are audited by the insurance company and have not followed the contract. You likely will have payment issues.
-
Jan 16 by mds1My Corp had me do an admission, and use that for 5 day, then the 14, 30 etc., i did, printed, then deleted.
