Responsibility for Tracking the 180-Day Benefit Sample Clauses

Responsibility for Tracking the 180-Day Benefit. ‌ The MCO shall be responsible for tracking accrual of days toward the 180-day SNF/NF benefit period for Enrollees to whom the benefit applies. During the 180-day benefit period, reimbursement for NF services provided by a Nursing Facility Provider can only be made through the MCO and not through the Medical Assistance fee-for-service claims system. Before Medicaid NF claims can be paid by the STATE, the MCO shall be required to provide documentation to the STATE demonstrating that it has paid for 180 days of SNF/NF services, using DHS-4461A. The STATE will verify the information documented by the MCO.
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Responsibility for Tracking the 180-Day Benefit. The MCO shall be responsible for tracking accrual of days toward the 180-day SNF/NF Benefit Period for Enrollees to whom the benefit applies. During the 180-day Benefit Period, reimbursement for NF services provided by a Nursing Facility subcontractor can only be made through the MCO and not through the Medical Assistance fee-for-service claims system. Before Medicaid NF claims can be paid by the STATE, the MCO shall be required to provide documentation to the STATE demonstrating that it has paid for 180 days of SNF/NF services and the STATE will verify the information documented by the MCO. Acceptable documentation shall include a claims record that contains the number of days paid to the Nursing Facility by the MCO. Acceptable notification shall include but is not limited to the following:
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Related to Responsibility for Tracking the 180-Day Benefit

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