MBRS reconciles all bills, tracks or files all corresponding claims and the reports on any payments owed by the trust. Medicare and most insurers now regulate how much physicians may bill patients. By reviewing bills before payment, MBRS ensures clients have been charged appropriately.

When clients pay their own bills or the total charge at the time of service, billing clerks may forget claims. MBRS needs to know when clients pay their providers so we can track the corresponding claims and the refunds that will be owed to them.

MBRS suggest that the trust pay monthly pharmacy bills (to avoid late fees and service charges) and then forward the original itemized receipts and statements. From the information we obtain on prescription drugs, MBRS can determine the identity of a client's attending physicians and follow the client's medical condition(s). We will also identify supplies that are billable to Medicare or other insurers and will track or file claims.

MBRS also tracks annual out-of-pocket expenses to determine why it may be feasible to consider a secondary policy or to upgrade an existing policy to increase coverage on prescription drugs.

Nursing homes may or may not be required to submit Medicare and insurance claims. They may or may not be allowed to collect the room/board, therapy and supply charges from a resident. We recommend that you always fax the first monthly statement after a new admission or when a client returns from a hospital... before you pay them. After that, forward them after you pay them and be certain to indicate the date and amount of payment.

When MBRS learns that an elderly client has been hospitalized we will determine if the client will be discharged temporarily to a skilled nursing facility for rehabilitation. When families must make placement decisions during stressful periods, they may not be aware that Medicare offers considerable coverage if the transfer is properly coordinated with the hospital, physician and nursing home. MBRS can obtain the information needed about a client's individual situation and report our findings so the trust can offer fact-based guidance to the client or his/her family.
Even when clients have been residents in nursing homes for many years, they may be entitled to Medicare reimbursement for up to 100 days when they return from the hospital. If they are discharged from a hospital to their home, they may be entitled to reimbursement on any rehabilitation services they receive in the home. MBRS will determine if the facilities or providers participate in the Medicare program and will report when the trust could become liable for unnecessary expenses.

Clients may need nurses or aides to take care of them in their homes so they don't have to live in nursing homes. Most will require medical supplies. Medicare and other plans may cover some or all of these expenses. MBRS monitors their needs and expenses and will let you know when reimbursements are available or when alternative services may be more cost effective. (Nurses and their agencies should be instructed not to order medical supplies without prior approval!)

Much of the medical equipment a client may require to remain at home is covered by Medicare and insurance policies, i.e., beds, wheelchairs, etc. "Buying" any of this equipment before allowing MBRS to review the purchase is a bad idea. (Nurses and their agencies should be instructed not to order equipment without prior approval!)