Sep 19, 2019
The Bottom Line

by Kim Cusson, CCS, CPC

Skilled nursing facilities (SNF) are not new, and yet there are often limited sessions at healthcare conferences that focus on the challenges that these organizations face. Education for the business office can be particularly difficult to find, but its members often wear multiple hats and serve as the last line of defense before a claim is submitted. The many tasks completed by billers and business office managers have reverberating effects on reimbursement, including the complicated and complex process of completing cost reports.

Sep 19, 2019
The Bottom Line

CMS will hold an open door forum on September 19 for SNFs and LTCs. Discussions will focus on:

  • PDPM updates
  • PBJ updates
  • MS-6058-FC Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process
  • SNF QRP resource update

If you wish to participate, dial 1-888-455-1397. Conference ID: 4676500

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.

Sep 06, 2019
The Bottom Line

CMS will be hosting an open-door forum on September 11 to discuss the status of new Medicare cards and Medicare Beneficiary Identifiers (MBI). Beginning January 2020, Medicare will only accept claims submitted with MBIs. The updated cards are designed to offer better identity protection by replacing social security numbers with unique MBIs. The new Medicare cards were mailed out in August.

Information regarding participation in the open door forum can be found here.


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Karen A. Thomas
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