Vol. 19, Issue 11, November 22, 2017
Nov 22, 2017
Billing Alert for Long-Term Care

Identity theft occurs when a thief steals a Social Security number, bank or credit card account information, or other documents containing personal information in order to commit fraud or for their own financial gains. Thieves use the information to get access to the victim’s personal assets and/or open new accounts and credit lines under the victim’s identity. Also, thieves can illegally obtain professional licenses, driver’s licenses, and birth certificates. Victims of identity theft are all ages, but those ages 50 and older are especially susceptible to scammers. According to Experian, approximately 2.6 million seniors are victims of identity theft every year. There are several reasons seniors are more vulnerable, including being uneducated about scams, being too trusting of others, and wanting to be independent in decision-making. Also, seniors are less likely to take preventive measures against identity theft. UCLA psychologist Shelley Taylor studied brain imaging and found that older adults may have less activity in the area of the brain that processes risk and subtle danger. Results from a survey issued by the AARP, Inc.,  revealed that the average age of victims of fraud and identity theft was 69.

Nov 17, 2017
Billing Alert for Long-Term Care

The UB-04 is a claim form suitable for billing multiple third-party payers. All payers will not require the use of the same data elements, so check with each payer to identify its individual requirements. In general, SNFs are required to submit the UB-04 electronically to all payers, in the 837-I format. This form can be submitted through electronic billing software programs in batch billing or through direct data entry (DDE) through the MAC. A provider filing a UB-04 should retain the copy designated “Institution Copy” and submit the remaining copies to its MAC, managed care plan, or other insurer. If a provider omits any required data, the MAC will return the claim for correction (which is called return to provider or RTP).

Nov 03, 2017
Billing Alert for Long-Term Care

Skilled nursing facilities and their partners are pushing hard to reform a half-century-old law that requires a hospital-inpatient stay spanning three midnights to qualify patients for Medicare coverage at nursing homes.

Led by the American Health Care Association, which represents 13,500 long-term and post-acute care facilities, a coalition of nearly three dozen national organizations is seeking to change the law,, contending the three-day stay requirement is outdated and denies Medicare beneficiaries access to medically necessary services.


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