Nov 01, 2019
 | 
Billing Alert for Long-Term Care

CMS issued its final rule, Fiscal Year 2020 Payment and Policy changes for Medicare Skilled Nursing Facilities (CMS-1718-F), in July. The new payment rule aims to “strengthen the Medicare program by better aligning payment rates for these facilities with the costs of providing care and increasing transparency so that patients are able to make informed choices.” Within the rule are three major updated provisions that will affect the operation of SNFs: the Prospective Payment System (PPS) payment policy, the Value-Based Purchasing Program (VBP), and the Quality Reporting Program (QRP).

Oct 24, 2019
 | 
Billing Alert for Long-Term Care

With the implementation of the Patient-Driven Payment Model (PDPM), SNF’s bottom lines are more at risk than ever before.

In these early days of PDPM, SNFs may find it difficult to project revenue and profitability for their Medicare Part A covered patients because so many factors, (e.g., patient acuity, clinical documentation, accurate ICD-10 coding) impact payment, says Kim Cusson, CCS, CPC, a consultant with Crowe Healthcare Risk Consulting, LLC.

Sep 26, 2019
 | 
Billing Alert for Long-Term Care

CMS announced proposed changes to the Medicare long-term care requirements that would reform “unnecessary, obsolete, or excessively burdensome” requirements for SNFs on July 17. The proposed rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P), fueled by the Trump administration, aims to reduce red tape surrounding SNF compliance and regulations.

Sep 13, 2019
 | 
Billing Alert for Long-Term Care

When it comes to knowing the difference between inclusions and exclusions in Consolidated Billing (CB), it can be extremely confusing for SNFs. Let’s first break it down by the basics. Included refers to items or services that are included in CB and for which the SNF must pay the outside vendor for specific services they provide. Excluded refers to items or services that are excluded from CB and may be billed by the outside vendor directly to Medicare Part B. Sometimes these items or services are also referred to as carve-outs.

Pages

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.

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.

swacusbk
jfitzgerald@hcpro.com
jfitzgerald@hcpro.com
tswartz@hcpro.com