stadells

The order and precert were dated the day after he was readmitted at about 8 pm, even though the skilled service was present on admission. So that's a good point, why NOT bill day 1 as Medicare? Does it really matter that the dates don't match up? I'm not familiar with billing and this scenario has caused a ruckus that I don't quite understand and I can't seem to find any information elsewhere.

A quick re-admission scenario followed by question: Resident is in a Medicare A bed but on Medicaid. He has a 3 day qualifying stay and meets all the criteria for Med A. However, the MDS Coordinator is not notified until the day after he returns to his Medicare A bed as Medicaid. A Utilization Review is held and the decision is made to begin Med A coverage that same day (the day AFTER admission). The order to begin Med A is written, dated the day AFTER admission. Accounting is notified that his first day back would be billed to Medicaid and his second day would be day 1 of Med A. Now, my question is: Is it possible to start Med A the day after return? Keep in mind the resident is not changing beds when beginning Med A because he was already in one. Does this cause issues with billing? Is it assumed by Medicare that the resident did not necessitate skilled services because he was not receiving them on day 1? I hope this isn't too confusing or too vague. I would truly appreciate any input.