In a recent report, the Office of Inspector General (OIG) determined that Medicare improperly paid for Skilled Nursing Facility (SNF) services when the Medicare three-day inpatient hospital stay requirement was not met. CMS developed the Skilled Nursing Facility 3-Day Rule Billing Fact Sheet to help you bill correctly.
Each year, the OIG identifies healthcare programs that are vulnerable to fraud, waste, and abuse through erroneous claims. Using claim sampling techniques and audits, the OIG identifies billing vulnerabilities and
concerns specific to SNFs. Results of these vulnerabilities are published as reports or listings of common errors and should be analyzed to determine whether they are concerns for your facility.
AMBR members have access to the new and improved members forum, where members can chat online about billing topics and find answers and advice as well as share best practices and experiences. Recently, members have discussed:
Billing for therapy on discharge day
Billing for the time therapists care plan
If you would like to join these conversations or start your own, sigin in here. The log in is the same as your AMBR log in credentials.
CMS issued its final rule, Fiscal Year 2020 Payment and Policy changes for Medicare Skilled Nursing Facilities (CMS-1718-F), in July. The new payment rule aims to “strengthen the Medicare program by better aligning payment rates for these facilities with the costs of providing care and increasing transparency so that patients are able to make informed choices.” Within the rule are three major updated provisions that will affect the operation of SNFs: the Prospective Payment System (PPS) payment policy, the Value-Based Purchasing Program (VBP), and the Quality Reporting Program (QRP).
Join Reg Hislop on Thursday, October 31 at 12pm EST as he discusses how to maximize revenue and minimize risk under PDPM. Register here.
More about AMBR quarterly calls
Each quarter, AMBR Director Tami Swartz will host a presentation with industry experts to discuss a variety of relevant and timely topics, including industry trends, updates, and best practices. Our members will receive guidance from, share opinions with, and have their questions answered by Medicare billing and reimbursement experts! AMBR members are welcome to present during these webcasts. Contact Tami Swartz at firstname.lastname@example.org if you are interested in being one of our volunteer speakers!