Outpatient Facility Coding Alert - 2016 Issue 1
Reader Question: Don't Change POS for SNF Patient in Office
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Article Overview
This reader Q&A explains a common SNF-related billing scenario in which a patient lives in a skilled nursing facility but is seen in an office setting. It discusses why the article matters for practices that bill Medicare or Medicare HMOs, and it outlines general guidance on consolidated billing, coordination with the SNF, and the need for written payment arrangements. The piece is useful for physicians, billing staff, and coders who handle post-acute care claims and place-of-service questions.
Why This Topic Matters
SNF resident billing can affect whether payment is made by Medicare Part B, a managed care plan, or the facility under consolidated billing rules, so practices need to understand the general reimbursement framework and facility coordination issues.
What You Will Learn
- How the article frames a place-of-service question for SNF residents seen outside the facility
- How consolidated billing affects payment responsibility in SNF-related services
- Why practices may need to coordinate with SNF administrators about a patient's stay status
- What general kinds of arrangements or contracts may be discussed between a practice and an SNF
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle personnel
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