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March 23, 2020---The Centers for Medicare & Medicaid Services  (CMS) has clarified its position on the use of swing beds, saying that swing beds can accept patients without a three-day inpatient stay. In a question and answer response to the issue, CMS stated the following: Q. Does waiving the requirement…
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Noridian uses scenarios for the parenteral administration of iron in non-dialysis patients. The Noridian iron infusion Local Coverage Determination (LCD) is important for just about everyone since Noridian is the Supplemental Medical Review Contractor (SMRC). Noridian could end up reviewing and denying your claims even if you’re not in Noridian’s…
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Expect more aggressive reviews of materials beyond the three-day criteria. Today I want to talk about skilled nursing facility, or as we often call them, “SNF” stays. For this, I’d like to start at the beginning. I’ll go all the way back to the Social Security Act. The reason to…
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Controversy Swirls: Payers vs Providers EDITOR’S NOTE: Attorney David Glaser reported this story live on Monitor Monday today. That statement may appear to be somewhat controversial, but it shouldn’t be. First, plans are required to provide the patient with benefits that are at least as generous as those required under…
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Medicare will waive any overpayment if the provider is without fault EDITOR’S NOTE: This is the first in a two-part series as to when facilities should voluntarily refund an overpayment. An often-overlooked provision of the Medicare statute protects providers and suppliers when they are not responsible for a mistake that…