Skilled Nursing Facility (SNF) Consolidated Billing (CB)

Consolidated Billing Background Prior to the Balanced Budget Act of 1997 (BBA), an SNF could elect to furnish services to a resident in a covered Part A stay, either: directly, using its own resources; through the SNF’s transfer agreement hospital; or under arrangements with an independent therapist. The consolidated billing requirement confers on the SNF […]

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How to Fill SNFABN (Skilled Nursing Facility Advanced Beneficiary Notice of Non-coverage)?

The SNFABN provides information to the beneficiary so that he can decide whether or not to get the care that may not be paid for by Medicare and assume financial responsibility. SNFs must use the SNFABN when applicable for SNF Prospective Payment System services (Medicare Part A).  SNFs will continue to use the ABN Form […]

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Common Denials for SNF and How to Avoid Them?

Denial 1: Certification or Recertification Statement (Missing/ Lacked Information) From 2012-2014 the percentage rate of improper payments to SNF almost doubled all stemming from failure to obtain certification or recertification. General Guidelines: The Certification Statement must include that the individual requires skilled nursing (furnished directly by or requiring supervision of skilled nursing personnel) or skilled […]

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How can wound care nursing change your life?

The image of nursing has come a long way from Florence Nightingale. Traditionally and generically, nurses have more than often been regarded as the healers of the medical world – healing patients with comforting words, tending their wounds, and dressings. The nursing profession is now no longer just a “calling” but offers a more professional […]

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Eliminating Skilled Nursing Facilities (SNFs) Medical Billing Complication

Medical billing for Skilled Nursing Facilities has undergone metamorphic changes ever since the Balanced Budget Act of 1997 came into effect in 1998. One of the significant requirements under the new legislation is that Skilled Nursing Facilities are not permitted to unbundle services that are administered by contracted healthcare providers. As a result, most of […]

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Reforming Nursing Facilities Medical Billing Amidst Dwindling Eimbursements

Nursing facilities across the U.S. have somehow endured a series of Medicare/Medicaid cuts thus far, but the latest move by CMS to reduce reimbursement for so-called Medicare “bad debt” – Medicare co-payments not made by beneficiaries or state Medicaid programs – may bring them on the threshold of a major operational crisis. The new legislation […]

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