tci Medicare Compliance & Reimbursement - 2019 Issue 7

Reimbursement: Sidestep Consolidated Billing Blunders With These 3 Tips

Know the payment rules associated with SNF patients. Occasionally, Medicare providers see skilled nursing facility (SNF) patients — and although those visits are not usually all that different from standard patient encounters, they can be vastly different when it comes to the billing rules. That’s because the government requires SNFs to “consolidate” their billing for Medicare Part A-stay residents, and all but a few services are excluded from the prospective payment system (PPS). Physicians who bill Medicare for services that are part of the all-inclusive PPS rate could be setting themselves up for payment recoupments and potential...

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