Your skilled nursing facility should adhere to the latest skilled nursing facility billing requirements. Any mistake in following the guidelines can lead your practice to encounter claim denials, no timely payments, and potential legal consequences. Staying on top of those guidelines is crucial for creating accurate invoices on time, reducing costly errors, and growing revenue. This article tells you about the latest billing guidelines in skilled nursing facilities.
SNF Services Billing
You are responsible for managing Medicare Part A reimbursement, which operates through the SNF Prospective Payment System (PPS) for services provided in approved nursing facilities and non-CAH swing bed facilities. CAH swing bed services, on the other hand, are reimbursed based on 101 percent of reasonable cost.
With consolidated skilled nursing facility billing, the responsibility for the entire care package during a covered Part A stay falls on you as the SNF. This includes all physical, occupational, and speech therapy services received during a non-covered stay. However, if the patient’s stay is covered by Part A, certain services are separately billable, as they are excluded from the consolidated billing arrangement. Those specific services are-
- Physician professional services
- Certain dialysis-related services
- Certain ambulance services
- Certain chemotherapy drug and administration services
- Radioisotope services
- Customized prosthetic devices
You’re the one who must remember that only therapy services are under consolidated billing for Medicare patients during a non-covered stay. All other covered SNF services can be billed separately.
When a visit is excluded from Part A coverage for any reason, you’ll bill Medicare Part B. Part B covers outpatient hospital services for non-SNF patients, services not included in SNF PPS and consolidated billing, and certain services provided to patients in an SNF when their Part A coverage has ended or they’re otherwise not eligible for Part A reimbursement.
Read More:
A Complete Guide on Skilled Nursing Facility Billing
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Updates in coding and documentation necessities:
It’s important to keep up with the newest coding and documentation rules from the Centers for Medicare and Medicaid Services (CMS) when you are dealing with skilled nursing facility billing. You need to be familiar with the updated diagnosis codes, ICD-10 codes, and documentation standards. This way, you can ensure that your records accurately represent the care and services you offer to patients.
So, now you might have realized that skilled nursing facility billing is not an easy job. It requires a dedicated team of billing professionals. Unfortunately, developing a billing team from scratch is a costly and time-consuming proposition and this is exactly where Sunknowledge plays a crucial role.
Outsource skilled nursing facility billing to Sunknowledge:
With a track record of excellence in skilled nursing facility billing, the team ensures your payments are prompt and efficient. Offering tailored support to streamline your practice management, Sunknowledge today acts as your complete operational partner at a much cost-effective rate.
Delivering customized support that helps in significant cost savings, up to 80%, for some of the industry’s biggest players in skilled nursing facilities, Sunknowledge’s preand post-billing support ensures optimal reimbursement for your services.
So, what are you waiting for? Discover how Sunknowledge prioritizes trust and excellence in service delivery. Take advantage of Sunknowledge’s expertise today to put an end to your worries.