Reply To: Your Questions!

[Tiffany]

In regards to the institutional vs. community explanation in Module 6, Day 2; On the final we report a 61 or 62 but what if the hospital or SNF hasn’t billed? You said to check but what if they have not billed? Do we hold the claim? I was under the understanding that Medicare would reprocess that claims once the inpatient facility submitted and their claim processed if a HHA should have been paid as institutional but was paid community because there were no inpatient claims on file. Have you found that having a 61 or 62 on the claim affects your payment if there are not inpt. claims on file? We have been working with our software to identify the billed vs. pd. HIPPS and are keeping track in a spreadsheet but curious as to what others are seeing.

• This reply was modified 2 years, 8 months ago by  Tiffany.