Master Consolidated Billing
Product Description:
AUDIOCONFERENCE ON TAPE OR CD
Sponsored by A Practical Guide to Consolidated Billing, Second Edition
presented on April 3, 2007
Ask yourself, “Did our SNF really need to pay for that ambulance ride?”
Consolidated billing is nothing new in long-term care—yet many nursing homes are still having a difficult time understanding the ins and outs of this confusing process. Often, SNFs pay the entire amount charged on a bill from an outside vendor—and they shouldn't.
Another challenge is how to handle vendors when they bill the SNF at rate that is often double or triple the Medicare fee schedule. SNFs don't realize that they should negotiate the amount, and that they should only pay for the services provided that are included in consolidated billing.
Listen to this 90-mintue audioconference, where our experts will explain the ins and outs of consolidated billing, and share resources to help your SNF stay on top of the complicated rules and regulations. During Master Consolidated Billing: Limiting Your SNF’s Financial Liability, experts Lee Heinbaugh and Ronald Orth, RN, NHA, RAC-CT, give listeners a breakdown of the services that consolidated billing includes or excludes, ensuring that your SNF only pays for the services for which it is responsible.
At the conclusion of this program, you’ll be able to:
- Identify the five major categories of consolidated billing
- Construct scenarios for which a SNF would and would not be responsible for paying for ambulance transport
- Explain how to review an unexpected bill for charges your SNF is not responsible for
- Recall critical CMS Web sites that will help you avoid unnecessary charges
AGENDA
- Five major categories
- 1 – Exclusion of services beyond the scope of a SNF
- 2 – Additional services excluded when rendered to end-stage renal disease (ESRD) beneficiaries
- 3 – Additional excluded services rendered by certified providers
- 4 – Additional excluded preventive and screening services
- 5 – Part B services included in SNF consolidated billing
- Ambulance services
- When the SNF is responsible for the bill
- When the resident must pay for the services
- When the ambulance company can bill Medicare directly
- Preventive measures
- A. How to avoid large, unexpected bills for services you thought were excluded from consolidated billing
- Invoice review best practices
- What to do when you receive a bill from an outside vendor
- Determining how much you should pay for such bills
- The Medicare Physician Fee Schedule
- Examples of bills you should not pay in their entirety
- CMS Web site tools
- The SNF consolidated billing file
- The HCPCS code file
- Other Web resources
A Q & A follows the presentation
MATERIALS INCLUDED IN YOUR PACKET!
In addition to the expertise and advice presented during this audioconference, you'll also receive
- CMS’s consolidated billing major categories document
- CMS’s billing invoice flowsheet
- Ambulance grid
- Examples of invoices with charges that should and should not be paid
- MLN Matters articles on different areas of consolidated billing
These materials are provided with PDF links.
MEET THE SPEAKERS
Lee Heinbaugh is a consultant with Pharmacy Management Group, LLC. After beginning her career in healthcare in the public accounting sector, she has continued to expand her expertise across the industry for the past 20 years. Her experience includes Medicaid, Medicare, and other third-party payment and reimbursement issues, including business office operational reviews, cost report preparation, and traditional accounting and bookkeeping services.
Ronald Orth, RN, NHA, RAC-CT, is a registered nurse with more than 25 years experience in the healthcare field, with 12 of those years in the long-term care industry. Orth serves as the lead instructor for HCPro's Medicare Boot Camp® - Long Term Care Version course. He is also President of Clinical Reimbursement Solutions, LLC a Wisconsin based consulting firm. Orth assists long-term care facilities by providing consulting and educational services related to long-term care Medicare regulations, billing, and compliance.
WHO SHOULD LISTEN?
- Billing office managers
- CFOs
- Billers
- Administrators
- Nurse managers
- DONs
- Social service staff
- Admission coordinators
Purchase a tape or CD of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
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