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Medicare Consolidated Billing

  1. #1
    Location
    Birmingham, Alabama
    Posts
    50
    Default Medicare Consolidated Billing
    Medical Coding Books
    I am new to Medicare consolidated billing and could use some experienced advice.

    I know with certain services that are done in the office for a patient staying at a skilled nursing facility, we can bill the nursing facility.

    What if the patient is having home health and Medicare recoups their money? How should we proceed then?

    Any advice would be appreciated!

  2. #2
    Location
    Alexandria, LA
    Posts
    518
    Default
    What did you bill, and why did Medicare recoup their money?

  3. #3
    Location
    Birmingham, Alabama
    Posts
    50
    Default
    We billed for occupational therapy.

    Medicare's reason for recouping their money was as follows: "Consolidated billing and payment applies."

  4. #4
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by paradoxy View Post
    We billed for occupational therapy.

    Medicare's reason for recouping their money was as follows: "Consolidated billing and payment applies."
    Then it may be the same as for Skilled Nursing consolidated billing. You would need to bill your services to the Home Health Agency responsible for the patient's care and they get reimbursed by Medicare for all services provided to the patient. Check with the agency.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  5. #5
    Location
    Birmingham, Alabama
    Posts
    50
    Default
    Thank you Arlene.

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