Therapy on discharge day

A Medicare Advantage Patient under Part A is in a certified bed. The patient has 6 units of therapy before discharge from Part A. The system shows the therapy as Part B. If the facility bills Medicare Advantage for the therapy, it will be denied because there was no pre-authorization.
Can the therapy charges be included on the Part A claim? What is the legal / proper way to handle the charges?

Comments

  • Can you clarify the question? Did the patient receive 6 units of therapy services after the Medicare Advantage last covered day? If so, there are some advantage plans that allow you to bill outpatient claims in the SNF without an auth. I would call the plan to get answers. If the services are outpatient and require auth, some plans have a process for submitting late auth requests.

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