Let’s Break Down the 3-Day Hospital Stay Rule for SNF Coverage in 2025 Okay, so here’s the deal: Medicare has this rule called the 3-Day Qualifying Hospital Stay Rule, and it’s super important if you’re dealing with SNF coverage in 2025. If a Medicare patient needs to go to a Skilled Nursing Facility (SNF) after a […]
As the need for senior care rises, the Centers for Medicare & Medicaid Services (CMS) is rolling out significant updates in 2025 that will reshape how Skilled Nursing Facilities (SNFs) handle billing. These changes include new regulations, updated reimbursement structures, and stricter documentation requirements. For SNFs, adapting to these updates is crucial to staying compliant […]
Understanding the billing processes in Skilled Nursing Facilities (SNFs) is crucial for residents and their families to manage healthcare expenses effectively. The Centers for Medicare & Medicaid Services (CMS) regularly updates guidelines that directly impact resident costs. In this blog, we’ll explore the fundamentals of SNF billing and highlight key changes from CMS’s recent guidelines. […]
Is Your SNF Billing System Leaving Revenue on the Table? It’s the year’s final quarter, and your Skilled Nursing Facility (SNF) is struggling with aged accounts receivable (AR) from months earlier. The services were provided, and the patients were cared for, yet a substantial portion of your revenue remains tied up in accounts receivable. Your […]
Individuals with complex medical needs benefit from skilled nursing facilities (SNFs), which consist of rehabilitation, long-term care, and hospice services. However, comprehending the nuances of billing and payback in SNFs can be difficult, resulting in lost earning opportunities. To maximize reimbursements, SNFs must implement proactive billing performance methods. In this article, we will discuss the […]
A skilled nursing facility (SNF) company follows the latest medical billing requirements. Failure to achieve this could bring about denied claims, no on-time payments, and possible legal action. Maintaining up with those adjustments is vital for making sure accurate and well-timed invoicing, fending off high-priced errors and denials, and growing revenue. The present-day guidelines are […]
Medicare Part A covers skilled nursing and rehabilitation care in a Skilled Nursing Facility (SNF) under certain conditions for a limited time. Coverage for care in SNFs is measured in ‘benefit periods’ or sometimes ‘spell of illness. In each benefit period, Medicare Part A covers up to 20 days in full. After that, Medicare Part […]
Determining Medicare Drug Coverage While billing for Skilled Nursing Facilities (SNF) or for hospital billing, billers always make the mistake of considering the wrong Medicare drug coverage. For example, Medicare Part A and Part B generally do not cover outpatient prescription drugs, most of which are covered under Part D. In this article, we shared […]
SNF Advanced Beneficiary Notice of Non-coverage Medicare requires SNFs to issue the SNF Advanced Beneficiary Notice of Non-coverage to Original Medicare, also called fee-for-service (FFS), beneficiaries prior to providing care that Medicare usually covers, but may not pay for in this instance because the care is not medically reasonable and necessary; or considered custodial. The […]
During the Public Health Emergency (PHE), The Centers for Medicare & Medicaid Services (CMS) used a combination of emergency waivers, regulations, and sub-regulatory guidance to offer healthcare providers the flexibility needed to respond to the pandemic. In certain cases, these flexibilities suspended requirements in order to address acute and extraordinary circumstances. Now, CMS is taking […]
