Ask the payment expert

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Ask the payment expert
Ask the payment expert
What is the value of having a daily “stand-up” meeting in our facility?

The daily “stand-up” meeting is an essential part of your strategic management of Medicare and case-mix Medicaid. Recently, we have seen more and more facilities that are deciding not to continue these meetings. That is not a good idea and we strongly suggest these meetings continue.

The structure of the meeting, however, is very important. It cannot be just a social meeting, should not last more than 15 to 30 minutes and should be truly a “stand-up” meeting. No chairs allowed!

The content of the meeting also is important. Your team should be discussing new residents scheduled for admission, their anticipated RUG levels and care needs. They also should discuss residents who are being discharged, making sure that all care goals have been met and verify that the proper notices (Expedited Review and/or ABN) were given.

Residents with potential change of condition should be discussed to identify if a Significant Change of Status assessment should be initiated. 


I recently heard that we have to bill Medicare for our managed care residents. Is that true?

If your managed care residents are part of the Medicare Advantage program and they are receiving Medicare funds for the residents' care, then the answer is yes. 

However, the purpose of the billing is not so that you get paid. It is to provide information to the Common Working File (CWF) so that Medicare can track the number of days used and the effect of those days on the benefit period. 

You can find more information on CR5653, which is effective on Jan. 1, 2008, by reading MLN Matters at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5653.pdf 
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