How have you separated medical expenses from room and board in care facilities?

At the risk of stating the bleedin' obvious... why, is the facility not providing itemised statements..?

Perhaps it's time they did..?

Background: Dad went from hospitalization to SNF for rehab, seguing into Palliative and then Hospice care. He remained at the SNF receiving hospice care until he passed earlier this month. Only difference was that the financial arrangements changed, and we pay for room and board in a lump sum.

I've received an invoice for the period from which he was no longer on Medicare, but as expected, there's no breakdown separating the medical and hospice aspect from the room and board. So I have no way of knowing the cost of the medical aspects.

I'll be addressing this with the billing department, and anticipate there might be some resistance to factoring out this detail. However, I would think that the detailed charting from the nurses would indicate which services are medical, so that the costs could be fairly easily segregated and provided in an updated invoice showing the room and board costs and the medical costs separately.

For those who've had to factor out these two different aspects, one reimbursable (amount and tax laws dependent), and the other private pay, do you have any suggestions from your experience to assist in getting an accurate amount for the medical and nonmedical costs? Did you ask for these breakdowns in invoices? Was there resistance to providing this level of detail, and if so, how did you overcome it?

Thanks for any suggestions.

CM, I don't know! Good question. I received the invoice the day after the billing specialist went on vacation, so I haven't been able to reach her yet. There aren't that many admins, especially for these kinds of tasks, so I'm waiting for her return.

I would have thought the breakdown would be provided automatically, but in the chaos of the last week or so I didn't think to ask while the billing specialist was still there.

Thanks for the quick response and the frank query on why this isn't done automatically!

Mom was on Medicaid and Hospice but no bill. Call the Hospice who cared for ur LO. Ask them what Medicared paid for. This way went you talk to billing you have an idea what they should be charging.

Good suggestion JoAnn. By starting with the Medicare billing, I can deduct that and determine what was paid for room and board.

The hospice team is the same group of nurses, aides, SW and others who provided SNF to PC to Hospice care - all in one facility, all the same non-profit. It was truly a turnkey facility.

Update: Decided not to wait for the biller to return on Monday; I've spent almost all day on trust work and want to make some tentative plans this weekend.

Spoke with someone else in the billing department and was a bit surprised at how this issue is handled. The company apparently aggregates costs annually and makes a determination of an (average?) amount expended on medical care vs. room and board. Medical costs ran around 44% for 2017, by this method. They do have standard rates for the facility usages, but medical costs can vary.

There is NO calculation of individual medical costs, so each patient could be above, or below the average.

So it seems to me that it's an average rate that applies to all patients on hospice care for that particular year. I won't know the rate for 2018 until the end of January, 2019.

Then it would still be based on the excluded amount of AGI, which would be very low since Dad passed in April.

I'm not sure I concur that this is a good method. I'll have to do a rough calculation to see if it'll benefit us.

Anyone else ever heard of something like this?

Garden Artist. I am sorry for your loss.