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RUG code

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  • noraphillips39
    I wonder, does anyone know what a RUG code is? My friend is doing homecare billing, and asked me. I ve not been able to find anything like that. Thanks
    Message 1 of 8 , Nov 14, 2006
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      I wonder, does anyone know what a RUG code is? My friend is doing
      homecare billing, and asked me. I've not been able to find anything
      like that.
      Thanks
    • Marni Richards
      RUG stands for Resource Utilization Group. RUG codes are used for billing Skilled Nursing Claims. A RUG code is assigned based on care that a patient
      Message 2 of 8 , Nov 14, 2006
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        RUG stands for Resource Utilization Group. RUG codes are used for
        billing Skilled Nursing Claims. A RUG code is assigned based on care
        that a patient receives and that in turn drives the reimbursement rate.

        Marni L. Richards
        Business Office Supervisor
        Santa Rosa Memorial Hospital
        Petaluma Valley Hospital
        707-525-5314
        Email: marni.richards@...

        >>> noraclaire@... 11/14/06 9:45 AM >>>
        I wonder, does anyone know what a RUG code is? My friend is doing
        homecare billing, and asked me. I've not been able to find anything
        like that.
        Thanks



        Notice from St.Joseph Health System:
        Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
      • noraphillips39
        Thanks Marni! That is a big help. It seems that it is similar in theory to a DRG then? ... care ... rate. ... anything ... privileged and confidential and
        Message 3 of 8 , Nov 14, 2006
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          Thanks Marni! That is a big help. It seems that it is similar in
          theory to a DRG then?



          --- In MedicalBillers@yahoogroups.com, "Marni Richards"
          <marni.richards@...> wrote:
          >
          > RUG stands for Resource Utilization Group. RUG codes are used for
          > billing Skilled Nursing Claims. A RUG code is assigned based on
          care
          > that a patient receives and that in turn drives the reimbursement
          rate.
          >
          > Marni L. Richards
          > Business Office Supervisor
          > Santa Rosa Memorial Hospital
          > Petaluma Valley Hospital
          > 707-525-5314
          > Email: marni.richards@...
          >
          > >>> noraclaire@... 11/14/06 9:45 AM >>>
          > I wonder, does anyone know what a RUG code is? My friend is doing
          > homecare billing, and asked me. I've not been able to find
          anything
          > like that.
          > Thanks
          >
          >
          >
          > Notice from St.Joseph Health System:
          > Please note that the information contained in this message may be
          privileged and confidential and protected from disclosure.
          >
        • Marni Richards
          Well.... a RUG code is a per diem rate so a Skilled Nursing Facility gets paid a certain amount for each day. The RUG can be reassessed at certain points in
          Message 4 of 8 , Nov 14, 2006
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            Well.... a RUG code is a per diem rate so a Skilled Nursing Facility
            gets paid a certain amount for each day. The RUG can be reassessed at
            certain points in the patients visit depending on their length of stay
            and that can affect their per diem rate. The DRG is a reimbursement for
            the entire visit based on the final dx. Does that make sense?

            Marni L. Richards
            Business Office Supervisor
            Santa Rosa Memorial Hospital
            Petaluma Valley Hospital
            707-525-5314
            Email: marni.richards@...

            >>> noraclaire@... 11/14/06 12:24 PM >>>
            Thanks Marni! That is a big help. It seems that it is similar in
            theory to a DRG then?



            --- In MedicalBillers@yahoogroups.com, "Marni Richards"
            <marni.richards@...> wrote:
            >
            > RUG stands for Resource Utilization Group. RUG codes are used for
            > billing Skilled Nursing Claims. A RUG code is assigned based on
            care
            > that a patient receives and that in turn drives the reimbursement
            rate.
            >
            > Marni L. Richards
            > Business Office Supervisor
            > Santa Rosa Memorial Hospital
            > Petaluma Valley Hospital
            > 707-525-5314
            > Email: marni.richards@...
            >
            > >>> noraclaire@... 11/14/06 9:45 AM >>>
            > I wonder, does anyone know what a RUG code is? My friend is doing
            > homecare billing, and asked me. I've not been able to find
            anything
            > like that.
            > Thanks
            >
            >
            >
            > Notice from St.Joseph Health System:
            > Please note that the information contained in this message may be
            privileged and confidential and protected from disclosure.
            >




            Notice from St.Joseph Health System:
            Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
          • noraphillips39
            Yes, that makes sense, but who (or what entity) determines what the per diem rate will be? ... Facility ... reassessed at ... stay ... reimbursement for ...
            Message 5 of 8 , Nov 14, 2006
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              Yes, that makes sense, but who (or what entity) determines what the
              per diem rate will be?



              --- In MedicalBillers@yahoogroups.com, "Marni Richards"
              <marni.richards@...> wrote:
              >
              > Well.... a RUG code is a per diem rate so a Skilled Nursing
              Facility
              > gets paid a certain amount for each day. The RUG can be
              reassessed at
              > certain points in the patients visit depending on their length of
              stay
              > and that can affect their per diem rate. The DRG is a
              reimbursement for
              > the entire visit based on the final dx. Does that make sense?
              >
              > Marni L. Richards
              > Business Office Supervisor
              > Santa Rosa Memorial Hospital
              > Petaluma Valley Hospital
              > 707-525-5314
              > Email: marni.richards@...
              >
              > >>> noraclaire@... 11/14/06 12:24 PM >>>
              > Thanks Marni! That is a big help. It seems that it is similar in
              > theory to a DRG then?
              >
              >
              >
              > --- In MedicalBillers@yahoogroups.com, "Marni Richards"
              > <marni.richards@> wrote:
              > >
              > > RUG stands for Resource Utilization Group. RUG codes are used
              for
              > > billing Skilled Nursing Claims. A RUG code is assigned based on
              > care
              > > that a patient receives and that in turn drives the
              reimbursement
              > rate.
              > >
              > > Marni L. Richards
              > > Business Office Supervisor
              > > Santa Rosa Memorial Hospital
              > > Petaluma Valley Hospital
              > > 707-525-5314
              > > Email: marni.richards@
              > >
              > > >>> noraclaire@ 11/14/06 9:45 AM >>>
              > > I wonder, does anyone know what a RUG code is? My friend is
              doing
              > > homecare billing, and asked me. I've not been able to find
              > anything
              > > like that.
              > > Thanks
              > >
              > >
              > >
              > > Notice from St.Joseph Health System:
              > > Please note that the information contained in this message may
              be
              > privileged and confidential and protected from disclosure.
              > >
              >
              >
              >
              >
              > Notice from St.Joseph Health System:
              > Please note that the information contained in this message may be
              privileged and confidential and protected from disclosure.
              >
            • Marni Richards
              The Government determines the rate. RUG rates are published in the federal register. These published rates are plugged into a formula that takes into
              Message 6 of 8 , Nov 14, 2006
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                The Government determines the rate. RUG rates are published in the
                federal register. These published rates are plugged into a formula that
                takes into consideration the individual facility's Wage index (which is
                determined by location), labor rate and non-labor rate. Additionally,
                there is an increased reimbursement for patients with AIDS. Here is a
                link to the Federal Register:

                http://frwebgate.access.gpo.gov/cgi-bin/multidb.cgi?WAISdbName=2006_register+Federal+Register%2C+Volume+71+%282006%29&WAISqueryRule=%28%24WAISqueryString%29&WAISqueryString=RUG&WAIStemplate=multidb_results.html&Submit.=Submit&WrapperTemplate=fr_wrapper.html&WAISmaxHits=40

                The first document that comes up is:

                fr31jy06N Medicare Program; Prospective Payment System and Consolidated


                Open it in the PDF format and you will get the tables.

                The CMS website will also have information regarding SNF billing and
                RUG codes.

                Marni L. Richards
                Business Office Supervisor
                Santa Rosa Memorial Hospital
                Petaluma Valley Hospital
                707-525-5314
                Email: marni.richards@...

                >>> noraclaire@... 11/14/06 1:43 PM >>>
                Yes, that makes sense, but who (or what entity) determines what the
                per diem rate will be?



                --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                <marni.richards@...> wrote:
                >
                > Well.... a RUG code is a per diem rate so a Skilled Nursing
                Facility
                > gets paid a certain amount for each day. The RUG can be
                reassessed at
                > certain points in the patients visit depending on their length of
                stay
                > and that can affect their per diem rate. The DRG is a
                reimbursement for
                > the entire visit based on the final dx. Does that make sense?
                >
                > Marni L. Richards
                > Business Office Supervisor
                > Santa Rosa Memorial Hospital
                > Petaluma Valley Hospital
                > 707-525-5314
                > Email: marni.richards@...
                >
                > >>> noraclaire@... 11/14/06 12:24 PM >>>
                > Thanks Marni! That is a big help. It seems that it is similar in
                > theory to a DRG then?
                >
                >
                >
                > --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                > <marni.richards@> wrote:
                > >
                > > RUG stands for Resource Utilization Group. RUG codes are used
                for
                > > billing Skilled Nursing Claims. A RUG code is assigned based on
                > care
                > > that a patient receives and that in turn drives the
                reimbursement
                > rate.
                > >
                > > Marni L. Richards
                > > Business Office Supervisor
                > > Santa Rosa Memorial Hospital
                > > Petaluma Valley Hospital
                > > 707-525-5314
                > > Email: marni.richards@
                > >
                > > >>> noraclaire@ 11/14/06 9:45 AM >>>
                > > I wonder, does anyone know what a RUG code is? My friend is
                doing
                > > homecare billing, and asked me. I've not been able to find
                > anything
                > > like that.
                > > Thanks
                > >
                > >
                > >
                > > Notice from St.Joseph Health System:
                > > Please note that the information contained in this message may
                be
                > privileged and confidential and protected from disclosure.
                > >
                >
                >
                >
                >
                > Notice from St.Joseph Health System:
                > Please note that the information contained in this message may be
                privileged and confidential and protected from disclosure.
                >




                Notice from St.Joseph Health System:
                Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
              • noraphillips39
                Marni, You have been incredibly helpful, and I can t tell you how much I appreciate your help. You made my day! ... formula that ... (which is ...
                Message 7 of 8 , Nov 14, 2006
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                  Marni,
                  You have been incredibly helpful, and I can't tell you how much I
                  appreciate your help. You made my day!


                  --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                  <marni.richards@...> wrote:
                  >
                  > The Government determines the rate. RUG rates are published in the
                  > federal register. These published rates are plugged into a
                  formula that
                  > takes into consideration the individual facility's Wage index
                  (which is
                  > determined by location), labor rate and non-labor rate.
                  Additionally,
                  > there is an increased reimbursement for patients with AIDS. Here
                  is a
                  > link to the Federal Register:
                  >
                  > http://frwebgate.access.gpo.gov/cgi-bin/multidb.cgi?
                  WAISdbName=2006_register+Federal+Register%2C+Volume+71+%282006%
                  29&WAISqueryRule=%28%24WAISqueryString%
                  29&WAISqueryString=RUG&WAIStemplate=multidb_results.html&Submit.=Subm
                  it&WrapperTemplate=fr_wrapper.html&WAISmaxHits=40
                  >
                  > The first document that comes up is:
                  >
                  > fr31jy06N Medicare Program; Prospective Payment System and
                  Consolidated
                  >
                  >
                  > Open it in the PDF format and you will get the tables.
                  >
                  > The CMS website will also have information regarding SNF billing
                  and
                  > RUG codes.
                  >
                  > Marni L. Richards
                  > Business Office Supervisor
                  > Santa Rosa Memorial Hospital
                  > Petaluma Valley Hospital
                  > 707-525-5314
                  > Email: marni.richards@...
                  >
                  > >>> noraclaire@... 11/14/06 1:43 PM >>>
                  > Yes, that makes sense, but who (or what entity) determines what
                  the
                  > per diem rate will be?
                  >
                  >
                  >
                  > --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                  > <marni.richards@> wrote:
                  > >
                  > > Well.... a RUG code is a per diem rate so a Skilled Nursing
                  > Facility
                  > > gets paid a certain amount for each day. The RUG can be
                  > reassessed at
                  > > certain points in the patients visit depending on their length
                  of
                  > stay
                  > > and that can affect their per diem rate. The DRG is a
                  > reimbursement for
                  > > the entire visit based on the final dx. Does that make sense?
                  > >
                  > > Marni L. Richards
                  > > Business Office Supervisor
                  > > Santa Rosa Memorial Hospital
                  > > Petaluma Valley Hospital
                  > > 707-525-5314
                  > > Email: marni.richards@
                  > >
                  > > >>> noraclaire@ 11/14/06 12:24 PM >>>
                  > > Thanks Marni! That is a big help. It seems that it is similar
                  in
                  > > theory to a DRG then?
                  > >
                  > >
                  > >
                  > > --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                  > > <marni.richards@> wrote:
                  > > >
                  > > > RUG stands for Resource Utilization Group. RUG codes are used
                  > for
                  > > > billing Skilled Nursing Claims. A RUG code is assigned based
                  on
                  > > care
                  > > > that a patient receives and that in turn drives the
                  > reimbursement
                  > > rate.
                  > > >
                  > > > Marni L. Richards
                  > > > Business Office Supervisor
                  > > > Santa Rosa Memorial Hospital
                  > > > Petaluma Valley Hospital
                  > > > 707-525-5314
                  > > > Email: marni.richards@
                  > > >
                  > > > >>> noraclaire@ 11/14/06 9:45 AM >>>
                  > > > I wonder, does anyone know what a RUG code is? My friend is
                  > doing
                  > > > homecare billing, and asked me. I've not been able to find
                  > > anything
                  > > > like that.
                  > > > Thanks
                  > > >
                  > > >
                  > > >
                  > > > Notice from St.Joseph Health System:
                  > > > Please note that the information contained in this message may
                  > be
                  > > privileged and confidential and protected from disclosure.
                  > > >
                  > >
                  > >
                  > >
                  > >
                  > > Notice from St.Joseph Health System:
                  > > Please note that the information contained in this message may
                  be
                  > privileged and confidential and protected from disclosure.
                  > >
                  >
                  >
                  >
                  >
                  > Notice from St.Joseph Health System:
                  > Please note that the information contained in this message may be
                  privileged and confidential and protected from disclosure.
                  >
                • Marni Richards
                  You are very welcome! I m glad I could help. Marni L. Richards Business Office Supervisor Santa Rosa Memorial Hospital Petaluma Valley Hospital 707-525-5314
                  Message 8 of 8 , Nov 15, 2006
                  • 0 Attachment
                    You are very welcome! I'm glad I could help.

                    Marni L. Richards
                    Business Office Supervisor
                    Santa Rosa Memorial Hospital
                    Petaluma Valley Hospital
                    707-525-5314
                    Email: marni.richards@...

                    >>> noraclaire@... 11/14/06 7:25 PM >>>
                    Marni,
                    You have been incredibly helpful, and I can't tell you how much I
                    appreciate your help. You made my day!


                    --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                    <marni.richards@...> wrote:
                    >
                    > The Government determines the rate. RUG rates are published in the
                    > federal register. These published rates are plugged into a
                    formula that
                    > takes into consideration the individual facility's Wage index
                    (which is
                    > determined by location), labor rate and non-labor rate.
                    Additionally,
                    > there is an increased reimbursement for patients with AIDS. Here
                    is a
                    > link to the Federal Register:
                    >
                    > http://frwebgate.access.gpo.gov/cgi-bin/multidb.cgi?
                    WAISdbName=2006_register+Federal+Register%2C+Volume+71+%282006%
                    29&WAISqueryRule=%28%24WAISqueryString%
                    29&WAISqueryString=RUG&WAIStemplate=multidb_results.html&Submit.=Subm
                    it&WrapperTemplate=fr_wrapper.html&WAISmaxHits=40
                    >
                    > The first document that comes up is:
                    >
                    > fr31jy06N Medicare Program; Prospective Payment System and
                    Consolidated
                    >
                    >
                    > Open it in the PDF format and you will get the tables.
                    >
                    > The CMS website will also have information regarding SNF billing
                    and
                    > RUG codes.
                    >
                    > Marni L. Richards
                    > Business Office Supervisor
                    > Santa Rosa Memorial Hospital
                    > Petaluma Valley Hospital
                    > 707-525-5314
                    > Email: marni.richards@...
                    >
                    > >>> noraclaire@... 11/14/06 1:43 PM >>>
                    > Yes, that makes sense, but who (or what entity) determines what
                    the
                    > per diem rate will be?
                    >
                    >
                    >
                    > --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                    > <marni.richards@> wrote:
                    > >
                    > > Well.... a RUG code is a per diem rate so a Skilled Nursing
                    > Facility
                    > > gets paid a certain amount for each day. The RUG can be
                    > reassessed at
                    > > certain points in the patients visit depending on their length
                    of
                    > stay
                    > > and that can affect their per diem rate. The DRG is a
                    > reimbursement for
                    > > the entire visit based on the final dx. Does that make sense?
                    > >
                    > > Marni L. Richards
                    > > Business Office Supervisor
                    > > Santa Rosa Memorial Hospital
                    > > Petaluma Valley Hospital
                    > > 707-525-5314
                    > > Email: marni.richards@
                    > >
                    > > >>> noraclaire@ 11/14/06 12:24 PM >>>
                    > > Thanks Marni! That is a big help. It seems that it is similar
                    in
                    > > theory to a DRG then?
                    > >
                    > >
                    > >
                    > > --- In MedicalBillers@yahoogroups.com, "Marni Richards"
                    > > <marni.richards@> wrote:
                    > > >
                    > > > RUG stands for Resource Utilization Group. RUG codes are used
                    > for
                    > > > billing Skilled Nursing Claims. A RUG code is assigned based
                    on
                    > > care
                    > > > that a patient receives and that in turn drives the
                    > reimbursement
                    > > rate.
                    > > >
                    > > > Marni L. Richards
                    > > > Business Office Supervisor
                    > > > Santa Rosa Memorial Hospital
                    > > > Petaluma Valley Hospital
                    > > > 707-525-5314
                    > > > Email: marni.richards@
                    > > >
                    > > > >>> noraclaire@ 11/14/06 9:45 AM >>>
                    > > > I wonder, does anyone know what a RUG code is? My friend is
                    > doing
                    > > > homecare billing, and asked me. I've not been able to find
                    > > anything
                    > > > like that.
                    > > > Thanks
                    > > >
                    > > >
                    > > >
                    > > > Notice from St.Joseph Health System:
                    > > > Please note that the information contained in this message may
                    > be
                    > > privileged and confidential and protected from disclosure.
                    > > >
                    > >
                    > >
                    > >
                    > >
                    > > Notice from St.Joseph Health System:
                    > > Please note that the information contained in this message may
                    be
                    > privileged and confidential and protected from disclosure.
                    > >
                    >
                    >
                    >
                    >
                    > Notice from St.Joseph Health System:
                    > Please note that the information contained in this message may be
                    privileged and confidential and protected from disclosure.
                    >




                    Notice from St.Joseph Health System:
                    Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
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