Press Release (ePRNews.com) - BLUE SPRINGS, Mo. - Mar 20, 2018 - The landscape of Long Term Care has become a difficult one to navigate. With regulation on the rise and reimbursement on the decline organizations are looking for cost effective ways to manage their residents. One way of doing this is through billing Part B Services. Through this cost savings measure organizations can not only save thousands monthly; but additionally, allows for a broader scope of treatment options for residents.
When a Medicare patient’s Part A stay ends, and your facility is no longer receiving a Medicare RUG payment, the patient assumes the responsibility for paying. If the patient needs certain supplies and they are covered by Medicare Part B. This in turn saves facilities money and allows for treatment options that may be cost prohibitive otherwise. Coverage consideration for DMEPOS items in a Skilled Nursing Facility (31) or Nursing Facility (32) are limited to the following:
• Prosthetics, orthotics and related supplies
• Urinary incontinence supplies
• Ostomy supplies
• Surgical dressings
• Oral anticancer drugs
• Oral antiemetic drugs
• Therapeutic shoes for diabetics
• Parenteral/enteral nutrition (including E0776BA, the IV pole used to administer parenteral/enteral nutrition)
• ESRD – dialysis supplies only
• Immunosuppressive drug
Guidelines for Coverage
Medicare has set forth certain guidelines for each item listed above. Residents must meet these guidelines for coverages to apply. This is where aligning yourself with a billing partner can really benefit. For specific question on what is covered this can also be found at https://www.cms.gov/Center/Provider-Type/Durable-Medical-Equipment-DME-Center.html.
Conclusion; weather you are billing ywlats in house or utilizing a third-party company this carve out allows for a broader spectrum of treatment options that historically could have been cost prohibitive a win-win for improving outcomes!
1. CMS “Your Medicare Coverage Part B services”
2. Department of Health and Human services (OIG)
About the Author Source :
Mark Hastings is the Co-founder and Chief Executive Officer of Impact Medical Services. Impact Medical is a Missouri based Durable Medical Company (DME) specializing in Part B Services. For more information please visit Www.Impactmedicalkc.com