Feb 21, 2020
Billing Alert for Long-Term Care

If every “i” is not dotted and every “t” not crossed when submitting a claim, an overpayment may result, even if services rendered to the patient were medically necessary. The appeals process is designed to give providers a chance to explain their case. It’s also a mechanism to make sure the audit was conducted properly. The following tips may not help you win every appeal, but they certainly won’t hurt your case.

Feb 14, 2020
The Bottom Line

The 2021 federal budget includes some aspects that SNFs may want to note. For one, it includes a proposal for site-neutral Medicare payments, a transition that would take five years and reduce the growth of post-acute payments. However, there is still more work to be done in that area. Another topic of concern is the expansion of prior authorization as a cost control measure by the agency. CMS seeks to target expanded authority to conduct prior authorization on certain items or services that are prone to high improper payments.

Feb 14, 2020
The Bottom Line

Recently, CMS released the proposed Medicaid Fiscal Accountability Regulation (MFAR) proposed rule, but according to a recent blog post by Seema Verma, CMS' administrator, the proposed rule is not intended to reduce Medicaid funding, as many fear. Instead, she argues, it is "aimed at strengthening accountability and increasing transparency to ensure that every Medicaid dollar is claimed and spent in accordance with federal law while supporting the interests of Medicaid recipients." She goes on to say that "nothing in our proposed rule would stop states from using supplemental payments, provided that they are used and financed in a way that is in compliance with federal statute and regulations."

Quarterly Member Calls

Members-only calls

Enjoy upcoming and past Quarterly Calls with your AMBR Membership! Click here!

Access sample white papers, tools, analysis, and resources.

Subscribe to our free e-Newsletter

The Bottom Line is a free weekly e-newsletter that delivers news, tips, and strategies for long-term care billing professionals and business office managers on operating an efficient and compliant billing office.

Click Here to Subscribe Now!

Featured Event

Tuesday, October 6, 2020 - 07:00

2019 Revenue Integrity Symposium

The 2020 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.

AMBR Forums

To participate in the AMBR forum discussions, you must be a member of the AMBR community. Please subscribe today or login for access.