LTC co pays about half of mom's skilled nursing bill. The nursing home billing system is impossible to understand. The LTC co delays payments when they turn in billing past a certain date, which I have reiterated numerous times to billing dept at skilled nursing. My DH did an account reconciliation spreadsheet over past year + and we are definitely short payments. There have been gaps in past with nursing home submissions. Do I have the right to get accounting from both entities after submitting our spreadsheet to them? Anything else I can do? Tracking all of this has been nightmarish. Luckily my DH is a numbers guy... Thank you for any advice!
These facilities MUST provide that accounting. If they don’t give you that accounting then you should threaten them that you will have your attorney call them to rectify the situation and you will definitely get results immediately.
Does LTC have to accept the bill directly from the Nursing facility? Is it possible for you to get the bills from the Nursing facility and submit them to the LTC company directly? To me, that sure beats trying to reconcile month by month and track down what goes with what....
I, personally, would get the records BEFORE I gave them your spreadsheet. You don't want any changes before you see them.
Best of luck. I am finding that the convoluted billing is becoming a business model and it is criminal IMO.