Author Topic: Medicare takeback SNF (Read 4454 times)

MFunk · « **on:** November 30, 2011, 06:18:23 PM »

Anyone know what is going on with Medicare. Last week they paid claims for our part b provider as usual. Seen patient in SNF. Used usual codes 99305-99308. Today they took money back. Stating the codes needed to be bundled for part b providers. There is nothing on website about policy change. I can't get anyone on phone. States they are too busy to take calls. Spoke with another office that is having same problem. They can't figure out why. They just got a letter requesting $$thousands back for the same thing. So I'm guessing I'll be seeing a letter like that too. ANYONE KNOW WHAT IS HAPPENING HERE???

CherylC · « **Reply #1 on:** November 30, 2011, 07:18:23 PM »

I don't do SNF billing but I did see the information below on another listserv that I thought may be helpful. I'm not sure who your medicare carrier is but I get the impression it's affecting all of the carriers.
Incorrect Skilled Nursing Facility Consolidated Billing â€” Reminder
Description of Problem
The Common Working File (CWF) System Maintainer has identified a problem impacting Skilled Nursing Facility (SNF) Consolidated Billing (CB) claims and coded a system correction that was implemented on Monday, November 21, 2011.Â
Â
The CWF is incorrectly denying some services excluded from SNF CB with the following reason code messages:
109 - Claim not covered by this payer/contractor.Â You must send the claim to the correct payer/contractor.
N538 - A facility is responsible for payment to outside providers who furnish these services/supplies/drugs to its patients/residents.
Â
What This Means to You
National Government Services is working with the Centers for Medicare & Medicaid Services (CMS) and the CWF System Maintainer to determine an appropriate course of action to correct any claims that were incorrectly processed.Â
Â
Current Status of Problem
11/22/2011-CWF is aware of this issue and they are working on a resolution. Providers are encouraged to read the E-mail Updates and to check for the status of this issue on the Production Alerts section of the National Government Services Web site.
Â
National Government Services, Inc.
Corporate Communications

MFunk · « **Reply #2 on:** December 01, 2011, 04:14:16 PM »

Finally got thru to Medicare. Turns out there was an error on their part for many providers. They are trying to fix. Thanks for taking the time to reply.

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