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.
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.
As CMS has undertaken the implementation of the Patient Driven Payment Model (PDPM), they are holding a limited number of SNF claims while they make further refinements to the claims processing system. PDPM was effective on October 1, 2019.
With the implementation of the Patient-Driven Payment Model (PDPM), SNF’s bottom lines are more at risk than ever before.
In these early days of PDPM, SNFs may find it difficult to project revenue and profitability for their Medicare Part A covered patients because so many factors, (e.g., patient acuity, clinical documentation, accurate ICD-10 coding) impact payment, says Kim Cusson, CCS, CPC, a consultant with Crowe Healthcare Risk Consulting, LLC.
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!