Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
CMS posted this notification today in MLN Connects – March 19, 2020:
SNF Claims Incorrectly Cancelled
From January 26 through February 16, 2020, a software issue caused Skilled Nursing Facility (SNF) claims to be incorrectly cancelled with a message that there was no three-day qualifying hospital stay. This issue is corrected. If your claims were incorrectly cancelled, re-bill them in sequential order to receive payment.
- Claims need to process in date of service order for each stay for the Variable Per Diem (VPD) to calculate correctly
- Submit claims in sequence and wait at least 2 weeks before billing subsequent claims
- Some of the affected claims with older dates of service will require a timely filing exception; enter “Resubmission due to non-qualifying stay” in the remarks field
- This issue was not caused by the recent implementation of the SNF Patient Driven Payment Model
- Contact your MAC to receive the Medicare Beneficiary Identifier (MBI) for deceased beneficiaries
Make sure to communicate this information to your billers!