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SNF Consolidated Billing Reminder for 2024: Are You Following the Requirements for Consolidated Billing?

The term consolidated billing includes services and/or equipment and supplies that are provided to a resident who is in a Skilled Nursing Facility (SNF) and being billed under Medicare Part A. The regulations outline who is responsible for paying for the services while under Medicare Part A. The consolidated billing rules eliminate the potential for duplicate billing for the same service and also allows the SNF to oversee and coordinate the total package of care…

Is Your SNF Involved in the “SPE” Yet?

As you should be aware, the Centers for Medicare and Medicaid put out a statement in Transmittal 12037 regarding the intention to have the Medicare Administrative Contractors (MACs) perform a five (5) claim probe and educate medical review on every Skilled Nursing Facility (SNF) in their jurisdiction. The purpose of this widespread review is to lower the SNF improper payment rate. This transmittal was published May 15, 2023. The reason for the audit was because…

Don’t Look Now, but There Are More E/M Changes Coming…

Just when you thought you were done learning all the new Evaluation and Management (E/M) Guidelines that were implemented in 2021 and 2023, hold on to your hats …. There are more changes coming. Not to worry though, they are minimal and do not involve a complete overhaul of the way E/M visits are coded. Looking back. In 2021, the codes for Office and Outpatient Evaluation and Management went from a system of counting elements…