Critical SNF Billing Requirements
Product Description:
AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE
Sponsored by The Medicare Boot Camp—Long-Term Care Version
presented on November 26, 2007
Keep up with critical changes to SNF billing.
No-pay billing regulations from CMS are in effect now. However, skilled nursing facilities (SNF) struggle to identify when they should use no-pay bills—and when they must submit benefits exhaust claims. Further, they may be setting up those claims incorrectly.
Adding to a billing professional’s confusion are new billing requirements for Medicare Advantage enrollees, as well as the waiver of the three-day hospital stay in certain circumstances. And SNFs can’t let these new changes go unnoticed, for fear of being out of billing compliance and facing claims denials or even medical review.
If you’re unsure about any of the above critical billing changes, you should listen to this 90-minute audioconference. Learn not only what the newest billing changes mean, but how they affect your facility, and what to do to ensure your facility receives proper reimbursement.
During Critical SNF Billing Requirements: No-pay billing versus benefits exhaust, experts Lee Heinbaugh, and Ronald Orth, RN, NHA, RAC-C provide case scenarios in which you will use a no-pay bill as opposed to when to use benefits exhaust claims. Then they will walk you through each type of bill with specific examples.
At the conclusion of this program, participants will be able to:
- Identify the differences between No Pay and Benefits Exhaust
- Understand the submission requirements for Medicare Advantage beneficiaries and waiver of the 3-day qualifying stay
- Learn when no-pay bills are appropriate
- Learn when benefits exhaust claims are appropriate
TAKE A LOOK AT OUR AGENDA
- No Pay Regulation (25 minutes)
- What is the purpose of the regulation
- Differences between a Benefits Exhaust and a No Pay (25 minutes)
- How to set up the No Pay Bill
- How to set up the Benefits Exhaust Claim
- Case scenarios of No Pay Bills and Benefits Exhaust Claims
- Other Billing requirements (10 minutes)
- Submission requirements for Medicare Advantage beneficiaries
- Waiver of the 3-day qualifying hospital stay
- Claim examples
- Q & A
NEW PURCHASE OPTION — AUDIO ARCHIVE
In addition to the regular participation option for HCPro audioconferences, audio CD, we are pleased to offer a new option, an audio archive. Audio archive allows you to download the program and play it back at your convenience through your computer or MP3 player.
ABOUT THE SPEAKERS
Lee Heinbaugh is founder and president of The Heinbaugh Group. After beginning her healthcare career 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. Other areas of expertise include risk assessments and implementation of corporate compliance plans, evaluation and implementation of automated accounting and billing systems, and business office personnel training.
Ronald Orth, RN, NHA, RAC-C, is the owner and President of Clinical Reimbursement Solutions, LLC. He has more than 20 years experience in the healthcare field, and has spent the past eight years specializing in the area of Medicare SNF Regulations and the PPS reimbursement system. Ron holds an Associate degree in Nursing and a Bachelor's degree in Health Care Administration. He also holds a Nursing Home Administrators license in the State of Arizona. Clinical Reimbursement Solutions offers an array on consulting services in the area of Clinical Reimbursement, for additional information visit clinicalreimbursement.com.
WHO SHOULD LISTEN:
SNF billers and finance directors, admissions staff, MDS coordinators, administrators, Medicare nurses, Finance personnel, business office managers, billers, coders, and admissions nursesBONUS TOOLS INCLUDED IN YOUR MATERIALS PACKET:
In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and tools, including
- List of Internet resources
- Paper copy of the UB-04
- Crosswalk between UB-04 and UB-92
- Immunization/Vaccine billing guide
- Copies of Cut Letter Notifications
These materials are provided with PDF links. Purchase a CD or audio archive 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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