Tag: HMO

Ask the expert: HMO resident concerns

Q: I live in Ohio. For a couple of years now we have completed our HMO residents in the following way: We complete an admission assessment only because we are not to submit PPS assessments on HMO residents. If that resident has a Medicaid number we code that in Section A. Subsequently these assessments are […]

Ask the expert: HMO coverage

Q: I am new to my current facility, but to my understanding the main biller wants us to submit all MDS assessments to CMS, even for HMOs, due to the facility not getting paid some time ago when the resident actually switched from a HMO to Medicare while they were in their 100 days. I […]