Find your copy of our exclusive AMBR Journal here. This quarter's issue contains in-depth features on:
MDS coordinators to take on quality
The onset of the PDPM marks another evolution for the MDS and MDS coordinators.
Experts uncover little-known risks and opportunities in PDPM
AMBR asked five long-term care experts to share key PDPM opportunities and risks that SNF providers may not have considered leading up to the transition.
Limit financial risk by enlisting billersto forecast profitability prior to admission
Determining and tracking the profitability of each potential new patient will be key to protecting the SNF’s bottom line in PDPM.
Consolidated billing made simple: Manage relationships
Proactively manage relationships with outside patients and external service providers to avoid costly consolidated billing mistakes
Facilities are required to use modifiers for HCPCS code R0075 (transportation of portable X-rays). The Centers for Medicare & Medicaid Services (CMS) created the modifiers so that a facility can report the number of residents served during a single trip. You should use these codes only if the X-ray equipment was actually transported to the nursing home.
Starting January 1, 2020, you must use the Medicare Beneficiary Identifier (MBI). We will reject claims you submit with the Health Insurance Claim Number (HICN), with a few exceptions and reject all eligibility transactions.
Developing a proactive internal approach to identifying and correcting billing issues before they become problematic is always good practice. Education and training on billing, coding, and documentation are essential. And as with any solid system, success depends heavily on continued monitoring of the process.
The Medicare Guide for SNF Billing and Reimbursement, Second Edition will help tackle the newest and most complex billing issues. This book will help billing staff understand the PDPM rate calculation methodology, identify opportunities to maximize reimbursement and accurately project revenue, correctly bill for Medicare Part A and Part B claims, and more!