A recent proposal by the Medicare Payment Advisory Commission (MedPAC) would have payments to post-acute providers based on a small number of risk-adjusted claims, according to a new proposal being drafted.
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.
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) penned a letter to CMS administrator Seema Verma in response to a tweet she published earlier in August. The tweet addressed the three-day rule, stating that a SNF resident must first spend three days as a hospital inpatient to be eligible for Medicare coverage, with Verma going on to call out that regulation.
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.
The Revenue Integrity Symposium (RIS) brings together some of the industry’s leading experts to train on the most relevant, hot-button issues in long-term care (LTC). It also helps establish a sense of community between providers, fostering opportunities for networking and relationship-building. This year’s symposium will be held October 15–16 in Orlando.
The Revenue Integrity Symposium (RIS) will bring opportunities for financial professionals to gain knowledge in their field by learning about what other experts have to say and what best practices may be beneficial for the Patient-Driven Payment Model (PDPM) transition. This year’s symposium will be held October 15–16 in Orlando.
There are a variety of PDPM sessions that will be beneficial to finance professionals in the long-term care (LTC) continuum.
I will be speaking on changes to the LTC billing process PDPM brings, such as a focus on weekly Medicare meetings, a triple-check focus, diagnosis code reviews, rejected claims, and gap billing.