NAMI is a Four Letter Word!
Every facility’s biggest problem is the collection of Net Available Monthly Income (NAMI). How many times have you heard: “I didn’t know I had to turn over mom’s income every month” or some variation on this theme. Have you considered sending a notification letter to all residents and designated representatives when Medicaid is or will be the third-party payor?
Notification as to the estimated NAMI budget should be sent to ALL Medicaid-pending residents as soon as Medicaid is determined to be the payor source, that is, even before the Medicaid Application is submitted. Do not wait for Medicaid approval. Approval of a Medicaid application can easily take up to one year. By then, the resident’s monthly income may be long gone. Instead, forward correspondence to the resident and/or their designated representative advising of the estimated NAMI amount as soon as you know that Medicaid will be the payor source.
The notice should outline the estimated NAMI due each month, the month said payments are expected to commence and the date upon which each monthly payment is due. The notice should include a statement that the calculation is only an estimate, subject to change upon issuance of the chronic care budget from the Department of Social Services/Human Resources Administration. As such, be sure to advise in the notice that the resident is responsible for any shortfall in the estimated NAMI dating back to the pick-up date and likewise, that the facility will refund any overpayments upon receipt of the chronic care budget.
Further, notice should be sent annually at the beginning of each year to all Medicaid recipients and Medicaid pending residents requesting their updated Social Security and pension payment figures for the new year. This way, your facility can invoice based on the increased income figures - without losing any time or money.
If you are uncertain as to a resident’s Medicaid pick-up date or faced with the situation where the resident’s family is not providing you with the required documentation, forward two invoices to the resident and/or their designated representative – one for the private pay amount and one for the anticipated NAMI amount. Nothing motivates a family more to cooperate in securing Medicaid benefits than seeing an invoice at the private pay rate.