So if the therapy sessions are being provided in the Residential Treatment Center (facility) by a licensed therapist and they are included in the daily rate; we can put those on a UB correct? example: using Rev codes 0914-0916
And if so do we have to show all charges since the insurance will not cover the room and board portion or can we just show the therapy sessions (they are included in the daily rate)?
I am trying to help out one of our patients to seek some reimbursement from the insurance.
I was giving you info because you said "what if we were participating" Since you are trying to help out a patient in the here and now, as NON par, again, YOU are only obligated to give them a breakdown of all charges and itemized with codes/diagnosis.
IF..you become par then you will have to break out "facility" charges on UB and "Professional" charges on CMS 1500.
While I can appreciate you trying to help a patient in your current situation, since you are non par the only thing I can say is that you provide them with a full breakdown of charges on an itemized bill that breaks out professional services and facility services. WHETHER they get reimbursement again, is really not something you can control on you end ASIDE from just giving them itemized bills.