SNFs and written agreements: Do it now

Why This Topic Matters

Without a clear understanding of SNF coverage and payment responsibility, practices may bill incorrectly or fail to obtain payment for services that are expected to be reimbursed by the facility. The article is relevant to offices that see Medicare patients from nursing homes and need a practical framework for protecting revenue and documenting payment arrangements.

Article Sections

1. SNF reimbursement and written agreements

   Introduces the reimbursement issue for patients arriving from nursing facilities and discusses why advance payment arrangements matter for practice revenue.

2. SNF eligibility and consolidated billing

   Summarizes general SNF coverage conditions and describes how consolidated billing affects responsibility for services and payment.

3. CMS guidance on outside provider payment

   Presents general CMS commentary on how payment arrangements between facilities and outside providers are handled.

4. Practical billing considerations for ophthalmology services

   Reviews broad billing considerations for professional services, procedures, drugs, and diagnostic testing when a patient is associated with an SNF.

5. SNF checklist

   Provides a concise operational checklist for identifying SNF patients, confirming coverage status, and documenting reimbursement arrangements.