one of those days

This has been of the craziest days ever! By the time I left the office tonight, I wasn't capable of maintaining a complete thought...

It's just insane. It is my belief that the federal government does not want providers to ever, EVER understand the Medicare system, and be able to work within it. I usually don't talk about this with people, because one, they really don't want to hear it, and two, unless you deal with it, you won't understand what I'm talking about. (OK, I know... nobody ever understands what I'm talking about anyway - I make no sense, EVER) But anyhoo -- Medicare has had this regulation on the books forever and a day, but have never enforced it... Hell, they haven't even had the system set up for it to be done! But now? Every SNF provider must submit a no-pay claim on any beneficiary who resides in a SNF bed, if Medicare A benefits are not being utilized for said stay. Now this really sucks, because most of our facilities are 100% dually-certified. So, that means they will have to submit a claim on every resident they have (either a pay claim or no-pay). Our software system is set up (finally, after I remembered every thing I was supposed to do) that it's a fairly painless procedure to create this batch of non-pay claims and review them... YEAH, RIGHT! Today, what should be impossible to have happened within the confines of the software, happened. And I know, when ever the software support tech finally gets around to reading my email, she will say, that can't happen, and that she was unable to duplicate the problem, and therefore, can't solve it. (Of course, this will be after she makes me explain the problem at least five times.) And the questions from the bookkeepers???? I get an email today -- 14 no pay claims rejected for overlapping with another provider's processed claim - What do I do? WTH? They're no pay claims! The end result is they will be in a reject status! Who gives a flying frik WHY they rejected? I don't care what reason Medicare gives for rejecting the claim -- I wasn't going to get paid for it anyway! And people want to argue with me about what diagnosis codes to use -- PEOPLE, IT DOESN'T MATTER!!! THEY ARE NO PAY CLAIMS! And if you don't like my answer, just say ok, hang up, and do whatever the fuck you want. I mean, hell, I sent you the regulation-- same damn thing I'm reading-- do you see where it specifies any of this shit? No? Then how the hell am I supposed to know, when Medicare doesn't even know? (of course, I could now veer off into how the customer service with our fiscal intermediary actually does know less than I do about Medicare, but I won't.) And don't argue with me about whether a no pay claim should be submitted on a resident on a VA contract. Are they in a Medicare certified bed? Yes? Do they have Medicare A benefits? Yes? Is Medicare A paying for their stay? No? Then you submit a no pay claim! I said that in the first email, or did you think when I said it doesn't matter what their payer source is, if it isn't Medicare A, then you submit a no pay claim, that I meant something totally different?
Oh, and to the person who sent me an email telling me that no, that wasn't what caused the VA contract residents' claims not to pull into the efile -- shut the fuck up. Obviously, you have no clue how our software system works, and I simply don't have the time to explain it to you. And let's be honest, YOU wouldn't understand it anyway. Your email was not helpful, and was in fact, a waste of time. Of course, it did reassure me that I never have to worry about you being a threat to my job. I would really love to tell that person that she could pick from the following reasons as to why what I said was correct: 1) I'm Freda, and I'm always right; 2) I'm just smarter than you; or 3) see #1 and #2.