tci Medicare Compliance & Reimbursement - 2013 Issue 7
Reimbursement: Adopt These 3 Billing Strategies for Nursing Facility Patients
Subscribe or sign in to view the full article.
Article Overview
This reimbursement-focused article covers practical billing management for physician services delivered to nursing facility patients under Medicare. It discusses consolidated billing at a high level, the importance of confirming whether a patient is in a Part A or Part B stay, and why some practices use contracts with facilities to address technical and facility-related services. The piece is aimed at physicians, billing staff, coders, and practice managers who work with nursing facility patients and want to understand the operational issues that affect payment and denials.
Why This Topic Matters
Billing for nursing facility patients can differ significantly depending on the patient’s Medicare stay status and the relationship between the practice and the facility. Understanding the article’s scope can help readers assess whether it addresses their reimbursement workflow, denial prevention, and contracting needs.
Article Sections
-
Study What Consolidated Billing Means
Introduces the Medicare consolidated billing concept and explains why nursing facility status affects how services are reported and paid. The section frames the broader reimbursement issue for physician services provided to facility patients.
-
Confirm Patient Status
Covers the operational need to verify whether a nursing facility patient is in a covered stay before billing. It emphasizes coordination with the facility and the role of status checks in avoiding denials and overpayments.
-
Set Up a Contract
Describes the use of agreements with nursing facilities to address payment for certain services and administrative expectations. It also references contract review and recordkeeping as part of the practice workflow.
What You Will Learn
- How nursing facility status affects Medicare billing workflows
- Why confirming a patient’s stay status matters before submitting claims
- How contracts with facilities can support reimbursement arrangements
- What kinds of billing and collection issues commonly arise with nursing facility patients
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.
Thank you for choosing Find-A-Code, please Sign In to remove ads.


Quick, Current, Complete - www.findacode.com