Can I fax a form to you?
What should I send along with my request form?
What do I need to send when I file an amended request?
Can a facility file for payment for additional days?
If I have a discrepancy in the number of TRICARE inpatient days, how do I prove to TRICARE that I am eligible for additional days?
Can a facility get a patient listing?
How long does a facility have to file for payment?
What if HCFA grants an extension to our facility for the Medicare Cost Report filing deadline?
Whom do I contact about recoupments?
Can our facility file for reimbursement for psychiatric days?
What if I don't know the number of days to file for?
Where can I find the TRICARE policy manual?
Can I fax a form to you?
We're sorry, but at this time we cannot accept faxed request forms because they must include the original signature.
What should I send along with my request form?
Please send the applicable pages of your Medicare Cost Report along with your completed, signed request form. See the 3 regulations above for more information on the applicable pages of the Medicare Cost Report.
What do I need to send when I file an amended request?
Along with the amended request for reimbursement, please send the audited pages from your Medicare Cost Report and a copy of the Notice of Program Reimbursement (NPR).
Can a facility file for payment for additional days only?
Under the 10/01/98 policy changes, providers cannot file a request for reimbursement for additional days only. Amended requests must result from a Medicare audit or desk review.
Can a facility get a patient listing?
Yes, a facility can get a patient listing after filing its initial request form for reimbursement.
How long does a facility have to file for payment?
Currently, a facility has 12 months from the end of its fiscal year to file for reimbursement. If a facility's fiscal year ends 06/30/05, it has until 06/30/06 to file for reimbursement.
What if HCFA grants an extension to our facility for the Medicare Cost Report filing deadline?
If HCFA grants your facility an extension for filing your Medicare Cost Report that exceeds your 12-month filing deadline for Capital and Direct Medical Education (Cap/DME) Reimbursement, just send a copy of the letter from HCFA when you send your request for reimbursement.
Whom do I contact about recoupments?
For questions about recoupments, call Penny Cross at (803) 763-6795 or email penny.cross@pgba.com
or Mary Bradford (803) 763-4952 or email mary.bradford@pgba.com.
Can our facility file for reimbursement for psychiatric days?
If your facility has a low volume psychiatric unit and Direct Medical Education (DME) costs, you can file for reimbursement of psychiatric days. Psychiatric days receive payment for DME costs only.
What if I don't know the number of days to file for?
If you don't know the exact number of inpatient days to file for, you can estimate the number of days.
Where can I find the TRICARE Policy Manual?
You can find the TRICARE Policy Manual online at http://www.tricare.osd.mil. (Reference the Reimbursement Manual