Billing and Payment of Separately Billable Medicare Part B or Equivalent Services Sample Clauses

Billing and Payment of Separately Billable Medicare Part B or Equivalent Services. Physical therapy, occupational therapy, and speech therapy services and other like services that may be treated the same for billing purposes under Medicare regulations, that are covered under Medicare Part B or insurance plans with substantially similar benefits as Medicare Part B and furnished to Residents of the Veterans Home who are not in a Medicare Part A covered stay (“Medicare Part B or Equivalent Therapy Services”) shall be furnished by Operator in accordance with Medicare and other insurance plan requirements. All such Medicare Part B or Equivalent Therapy Services shall be billed to Medicare or the applicable insurance plan by Operator in the name of the Board and using the Medicare provider number or other identifier assigned to the Veterans Home. The Board shall pay to Operator for such Medicare Part B or Equivalent Therapy Services a per unit fee equal to the Medicare allowable amount, as published in the Medicare fee schedule for the year in which the service is furnished, for each such Medicare Part B or Equivalent Therapy Service furnished by Operator. For Medicare Part B or Equivalent Therapy Services, the Board shall promptly pay the eighty-percent (80%) portion billed to Medicare or other applicable payer after receiving such funds from Medicare or the payer. Operator shall xxxx the remaining twenty-percent (20%) coinsurance amount to the appropriate payer on behalf of the Board, and the Board shall pay Operator said coinsurance amount within ten (10) days of the earlier to occur of (i) the Board’s receipt of such funds from the payer, or (ii) Operator’s transfer of such coinsurance receivable to the Board upon exhaustion of Operator’s standard collection procedures.