billing medicare ky after pt has died

[sherry27]

I am billing medicare for pts that were seen in the hospital. I beleieve I got a rejection before for this. The pt is dead now. Does medicare need something else. I am billing on a cms 1500 form. Your help will be appreciated. Thanks

[Michele]

Are you saying the claims were rejected because the pt was deceased?  Medicare will pay for any services prior to the date of death so I'm thinking the denial was probably for a different reason?

Michele

[sherry27]

Thank you for your answer. No, I didn't get a rejection yet for this patient. I went on and put date of death on the claim too. Actually this is not just one pt. I only sent out 10 pts this morning for consecutive days in the hospital and 5 of those pts are dead when I checked eligibility..OUCH!!

[PMRNC]

Ouch, is right, remind me to make sure that's not my doctor lol

But Michele is right, as long as the DOS are prior to the patient's death they should be covered, if you receive a rejection it is possible that another provider provided same levels of service on same days in which case whomever gets paid depends on who gets their claims in on time.

[Steve Verno CMBS, CEMCS]

When asking a question, it helps to have as much information as possible.  If you have a rejection or denial we need to know the reason provided by the insurance company for the rejection or denial.

Otherwise, you will be provided many answers that can be different yet each could be right or wrong. 

There is no need for PHI on the patient themselves. 

[Michele]

I was told by my Medicare once that even if the patient is deceased, not to put the date of death on the claim.  She said it messes up the processing.

Michele

[PMRNC]

This goes to show you that it sometimes comes down to who you talk to on the phone. Procedure says that if you know the date of death it should be on the claim.
When I was a claims examiner the only thing that date in that field did was scan for services on or after it to make sure there were no claims for after the death, that's all that field is for. Most times the system didn't even know that date was there UNLESS it cross referenced a claim in the system for After the deceased date.
But again, I'm not going to guess because we don't really know the denial reason from the carrier.

[rdmoore2003]

why exactly do you think you have rejections if you have not received the eob?

[sherry27]

Thank you guys so much for your replies. I haven't had a rejection on these that I am billing right now. When I said "I think I got a rejection before on this" This was several years back, but I remember it was something to do with the date of death. I'm keeping my fingers crossed this goes through the first time. It is so nice having people to go to ask  these questions. Thank you Michelle and Alice for this forum

[dawn]

make sure they have the correct dod listed on the Medicare site, I've had rejections for this and had to send them a death cert. to prove dod.
Also was you Doctor treating for the same reason of death? EX: if your Doctor was treating the patient for a bed sore, but the patient expired from cancer...you can add a GW modifier to your claim to show that the diagnosis is not related to the reason for death