Potential Medicare bad debt changes [PODCAST]
Welcome to the hospital finance podcast, you're go to source for information and insights that can help you stay ahead of the challenges impacting healthcare finance, and now the host of the hospital finance podcast Michael Pass Naughty. Is, Mike, Pasadena Welcome back to the award winning hospital finance podcast. And the twenty twenty one I. Proposed rule, CMS is proposing to amend its existing bad debt regulations for the upcoming fiscal year to tell us about those proposed changes and their implications I'm joined by Jay Lin senior consultant on the reimbursement services team at bessler JC welcome to the podcast. Thank you Mike always great to be on the podcasts always great to have you, so let's start out as I mentioned in the opening. CMS is proposing some changes to its bad policies. What are they proposing and why? Is always been the age old question as to how cms. Is always updating their quote. Unquote reimbursement requirements, and it's always been a mystery for the hospital twenty. Keep up with all the requirements, and basically CMS propose to cofidis requirements of additional requirements. The hospital must satisfy. Debts from Medicare through this particular published notices and comments rulemaking. And if CMS doesn't do it then. They won't be able to enforce these particular. Updated requirement, and so the fact that cms proposed adapt some of the. Requirement actual actively. Santa find that CMS. Intense to apply these rules to open war, we open a bowl. Pass Haas reports. Think retroactive is the key there, isn't it? Yes it is, and so at this point in all the hospitals are on the hook to be able to get the reports. We open without their proper management. JC water the new proposed minimum requirements for bad. Debts It's not really the oppose the new requirements just to up there and reinforce their requirement that hospitals must be all manicure beneficiary no later than hundred and twenty days after the day of the Medicare, we missed vice and the new of quote. Unquote updated regulation would also bar hospitals from running off about that sooner than hundred twenty one days after issuing the bill. Now with keeping I one hundred and twenty one day period would reset each time. The patient makes a partial payment. CMS well prohibited hostile to claim that that that is written off to a contractual account as hostile must claim that that's. is written off to a bad debt expense account. In the providers, financial rutgers, and that is the key. Is Typically a hospital would write it off to their contractual allowance as soon as they get a type of transaction on the hospital from the excuse me from the patient or from their insurance policy. Let's say for Medicare Medicaid accounts and there was just simply ran off on their own. But now, the Medicare would like to see that it's written off to the actual bad debt expense. So that is the big. That is to be updated change at this point. Got, it an individual claims should be filed with the cost report filing. What are the minimum fields required to do this correctly? Yeah. That's that's always been the same format. That cms has reinforced the year. They're. Medicare even meteors in the past, so that there's no change, but again all hostile should keep in mind that they are the ten minimum. We choir feels in order to for them to reimburse for about that account. and. The accounts on the field. In the data should be have minimum to have at least ten field, and they would include the patient name. The social security number in the data service along. Whether a patient. Qualify for the indigent right off whether that with through their mean of tasks of income or a simply have both Medicare and Medicaid coverages at any given point edge. And then lastly they would show the day of the service that the beneficiary was. Sent a quote Unquote Bill in order to show that they're fair share of air, deductible and co-insurance along with the. That we survive day, and then lastly the most important view is the balance of the account, basically the simply show the patient that they have what's do fully done they the Medicare bad that regarding that manicured deductible on co-insurance and. So those are. The very minimum required for me and each hospital can definitely go through what their standard format that they have in their system, and they should be able to extract those important feel in order to qualify for a manicure that that reversing. God and JC, what do you think these changes are going to mean for hospitals going forward? Well am I just simply makes it harder and harder for hospitals to receive that reimbursement. It appears that CMS is making changes to flood longstanding policies that have existed for decades. If not since the time. The miniature deduct the foreign co-insurance have existed. But at least we carbon, the hospital must factor patient. We sources and acids in making the charity care decision is a significant and substantial change on the past policy. And Medicare? Would likely pay more attention. In the Lao in bad that claims in the Kospi reports in general. And therefore each hospital's Medicare reimbursement for bad debts will be harder and harder to be allowed to the caution. JC thanks so much for coming by the podcast today and helping us all understand more about upcoming changes to bed debt. Yeah. That's always my pleasure, and it's always just A. It's easier said than done, so he chaucer Shit. Definitely pay attention to all these on a requirement. Thanks chasing. This concludes today's episode of the hospital finance. PODCAST for show notes and additional resources to help you protect and enhance revenue at your hospital visit Bessler dot com forward slash podcasts. The hospital finance podcast is a production of bessler smart about revenue tenacious about results.