How does SeniorCRE bill bed-hold and leave-of-absence days correctly under state-specific Medicaid rules?
Bed-hold and LOA day billing varies by state — some states pay a percentage of the per-diem for hospital leaves, some require a written family election, some cap at a number of days per year. The rule lives in the business-office manager\u2019s head. When the manager is on vacation, the LOA days get billed wrong, the state denies the days, and revenue is lost or — worse — the operator bills days it was not entitled to.
Detail
Each state\u2019s Medicaid bed-hold and LOA policy is encoded with effective dates, eligibility rules, daily rate calculation, family-election requirements, and per-year caps. A hospital transfer or therapeutic leave triggers a workflow: required notice timing, family election form, payer notification, and the per-diem the system bills against the LOA day. The 24-hour and 5-day clocks run automatically; missed family elections surface before the day is billed.
Bed-hold revenue captured against the state policy goes from "whatever the BOM remembered" to systematic. State Medicaid audits find no overbilled LOA days because the rule applied was the rule the system encoded.
Key points
- PointClickCare Census
- MatrixCare
- State Medicaid bed-hold portals
https://seniorcre.com/workflows/financial/bed-hold-and-loa-billing