Consolidated Billing: 3 Simple Steps Put You on the Path to Capturing Payment for Your Nursing Facility Services

Why This Topic Matters

Nursing facility billing can affect whether payment is sought from Medicare or from the facility, so understanding the general process helps practices avoid denied claims and missed reimbursement. The article is relevant for organizations that bill for physician services, diagnostics, supplies, and related encounters involving nursing facility residents.

Article Sections

1. Understand Consolidated Billing and How It Affects Your Practice

   Introduces the consolidated billing concept and explains its impact on reimbursement for services furnished to nursing facility residents. The section frames the general distinction between facility-related and physician services.

2. Check the Patient's Status

   Describes the importance of confirming whether a resident is in a Part A or Part B stay before billing. It emphasizes contacting the facility and using current census information rather than assumptions.

3. Leave the Professional Portion to Medicare

   Covers the general separation of professional and technical components for services provided in the office to nursing facility patients. It also discusses how claims handling differs when a patient is in a covered nursing facility stay.