Apr 26, 2018
The Bottom Line

The Billers’ Association is seeking long-term care managers, revenue cycle enthusiasts, and billing professionals to join our growing ad-hoc list of experts interested in contributing to articles in our monthly publication, Billing Alert for Long-Term Care. This digital newsletter provides expansive regulatory coverage, including MDS changes, reimbursement issues, and expert advice and analysis to help improve job performance in all aspects of the revenue cycle management system.

Dec 22, 2017
The Bottom Line
Q: Is the physician the only person who can enter information in the electronic health record (EHR) in order to qualify for the Medicaid EHR Incentive Programs?
Oct 13, 2017
Billing Alert for Long-Term Care

Since its introduction in the skilled nursing facility (SNF) setting, consolidated billing (CB) has been one of the most routine yet misunderstood methods for SNFs to secure Medicare reimbursement.

To better grasp the complex principles, regulations, and systems that surround consolidated billing, SNFs must first have a solid foundation in Medicare Part A coverage and criteria. Without a basic understanding of this powerful insurance plan, SNFs risk committing or contributing to a number of punishable payment offenses, including improper billing, over- and underpayments, fraud, and abuse-related Medicare infractions that can carry serious ramifications, including steep penalties, exclusion from the program, imprisonment, or any combination thereof. 


The below Q&A contains questions that have been transcribed from our live webinar show, “Consolidated Billing for SNFs: A Close Look at the Five Major Categories,” hosted by expert speaker Janet Potter, CPA, MAS, senior manager, advisory services for Marcum LLP, and from frequently asked questions included in Potter’s new book, Medicare Guide for SNF Billing and Reimbursement. For more information on CB for SNFs, listen to the on-demand show or purchase our newly released Medicare billing guide.

Mar 03, 2017
Billing Alert for Long-Term Care

There are few times during a SNF stay that a resident is more vulnerable than those first several days. Often, a bad transition process only serves to exacerbate those vulnerabilities, leading to complications or rehospitalization.

In fact, a  study published in the Journal of Post-Acute and Long Term Care shows that poor coordination between hospitals and postacute care providers can have devastating consequences for residents, particularly those with higher acuity.

Feb 10, 2017
The Bottom Line

In the Fiscal Year (FY) 2016 SNF Prospective Payment System (PPS) final rule, CMS adopted the SNFRM as the first measure for the Skilled Nursing Facility Value Based Purchasing (SNF VBP) Program. The measure is defined as the risk-standardized rate of all-cause, unplanned hospital readmissions of Medicare beneficiaries within 30 days of discharge from their prior hospitalization. Hospital readmissions are identified through Medicare hospital claims (not SNF claims) so no readmission data is collected from SNFs and there are no additional reporting requirements for the measure.

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Tuesday, October 15, 2019 - 07:00

2019 Revenue Integrity Symposium

The 2019 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.

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Karen A. Thomas
Victorine Courtois