Long-Term Care Articles by Topic: Billing and Reimbursement
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MDS 3.0 Insider, Issue 11, March 15, 2013
In 2012, Recovery Auditors continued to expand their reach and gain speed. How has your facility...
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MDS 3.0 Insider, Issue 16, August 8, 2011
The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for SNF PPS and...
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MDS 3.0 Insider, Issue 14, July 11, 2011
With 2013 seemingly so far away, many post-acute care organizations, including long-term care...
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MDS 3.0 Insider, Issue 13, June 27, 2011
Q: How can we tell if this resident can access her remaining Medicare Part A days?
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MDS 3.0 Insider, Issue 10, May 16, 2011
During the May 12 SNF Open Door Forum (ODF), CMS provided callers with information about what was...
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MDS 3.0 Insider, Issue 5, March 7, 2011
Q: I work in Pennsylvania and the use of V-codes has been an ongoing issue in this area. With the...
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MDS 3.0 Insider, Issue 3, February 7, 2011
CMS recently announced that they had made an error with a non-labor share percentage used for...
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MDS 3.0 Insider, Issue 1, January 10, 2011
The Centers for Medicare & Medicaid Services (CMS) recently released the Medicare Learning...
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MDS 3.0 Insider, Issue 24, December 27, 2010
As the end of the year approaches, it is important that Medicare Fee-For-Service (FFS) physicians...
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PPS Alert for Long-Term Care, Issue 11, November 1, 2010
With a whoosh, a zoom, and what probably seems like a whack, MDS 3.0 has begun. You’ve been...
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MDS 3.0 Insider, Issue 19, October 18, 2010
MedPac released an updated 2010 Medicare Payment Basics series October 14, which provides an...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2010
Inside:
Keep your claims error-free with a simple check
HCPCS update and the HCFA 1500
Preparing...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2010
Lee A. Heinbaugh answers readers questions about Medicare Part A eligibility, settling financial...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2010
In many ways, Part B billing rules are quite different from Part A rules. However, your SNF must...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2010
On June 1, CMS implemented a number of changes to the Medigap program, including the creation of...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2010
Inside:
Mindful of Medigap and consistent with coinsurance
CMS answers your ICD-10...
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The Center for Post Acute Excellence Update, Issue 4, July 5, 2010
Contracts and contractual law are important for long-term care administrators to understand. A...
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Contemporary Long-Term Care Weekly, Issue 26, July 1, 2010
The House passed a six-month plan, known as the doc fix, on June 24 that repeals a 21% reduction of...
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Billing Alert for Long-Term Care, Issue 7, July 1, 2010
Few topics are as puzzling to SNF billers as no-pay bills and benefits exhaust claims...
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Billing Alert for Long-Term Care, Issue 7, July 1, 2010
The July issue of Billing Alert for Long-Term Care covers no-pay bills and benefits exhaust claims...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2010
Healthcare reform means a lot of different things to a lot of different people, but for Medicare...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2010
Every day in SNFs across the country, information enters and exits, moving through the various...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2010
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Contemporary Long-Term Care Weekly, Issue 21, May 27, 2010
In a notification released May 24 via the listserv, CMS addressed the immediate need for a grouper...
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MDS 3.0 Insider, Issue 9, May 17, 2010
Q: If I am providing concurrent therapy to two resident for one hour, can I bill both for one hour...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2010
As the competitive bidding program progresses, durable medical equipment, prosthetics, orthotics...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2010
By carefully and accurately filling out the MSP form with every admission, understanding the...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2010
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Contemporary Long-Term Care Weekly, Issue 16, April 22, 2010
On April 19, CMS released a hospital inpatient and long-term care prospective payment system...
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Contemporary Long-Term Care Weekly, Issue 14, April 8, 2010
Under the Patient Protection and Affordable Care Act, which President Obama signed into law March...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2010
No facility wants to experience a payment ban, which halts Medicare Part A payments for new...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2010
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 3, March 1, 2010
Synopsis: Though it may not be a SNF’s ideal means of reimbursement, billing Medicare Part...
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Billing Alert for Long-Term Care, Issue 3, March 1, 2010
The implementation of MDS 3.0 on October 1 means big changes for SNFs. The latest PPS assessment...
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Billing Alert for Long-Term Care, Issue 3, March 1, 2010
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2010
How can a provider protect the revenue it earns through therapy services? The answer is...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2010
Automated reviews lurk under the radar of SNFs. An automated review is a non-human RAC...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2010
Getting a firm grasp on consolidated billing is hard enough. Tack on the situation-dependent...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2010
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Contemporary Long-Term Care Weekly, Issue 3, January 21, 2010
The Minimum Data Set (MDS) drives all billing, including consolidated billing. It is a federal...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2010
Diagnostic tests are subject to the annual Part B deductible and the 20% coinsurance payment. Each...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2010
Even though many of the triggers are quick fixes, failing to respond to an ADR can result in...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2010
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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LTC Educator's Corner, Issue 7, December 7, 2009
Similar to Part A services, facilities can bill Part B ostomy, urological, and tracheostomy...
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Briefings on Long-Term Care, Issue 12, December 1, 2009
Lee Heinbaugh and Diane Brown discuss claim due dates, midnight census, leaves of absence, and...
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Briefings on Long-Term Care, Issue 12, December 1, 2009
A large percentage of residents require the services of a SNF for skilled nursing and...
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Briefings on Long-Term Care, Issue 12, December 1, 2009
In the last couple of years, and especially in recent months, many long-term care professionals...
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Briefings on Long-Term Care, Issue 12, December 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2009
Lee Heinbaugh and Diane Brown discuss claim due dates, midnight census, leaves of absence, and...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2009
A large percentage of residents require the services of a SNF for skilled nursing and...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2009
In the last couple of years, and especially in recent months, many long-term care professionals...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2009
With more people buying long-term care insurance, which often provides coverage beyond the...
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Contemporary Long-Term Care Weekly, Issue 43, November 1, 2009
The Centers for Medicare & Medicaid Services (CMS) released the much anticipated final MDS 3.0...
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PPS Alert for Long-Term Care, Issue 11, November 1, 2009
Columnist Wayne van Halem, AHFI, CFE, discusses what to do when an internal audit reveals billing...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2009
Having RFP troubles? Look no further. Lee Heinbaugh discusses request for proposal from a billing...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2009
The therapy cap exception process is set to expire December 31. As of now, the only action on this...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2009
The intricacies of consolidated billing continue to challenge even the most experienced billers.
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Billing Alert for Long-Term Care, Issue 11, November 1, 2009
Billers can establish an efficient business relationship between their facility and their MAC...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Contemporary Long-Term Care Weekly, Issue 41, October 22, 2009
Administrators need to understand a few basic rules when dealing with the consolidated billing...
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MDS 3.0 Insider, Issue 27, October 5, 2009
Q: How will the judgment to divide concurrent therapy minutes among the residents receiving the...
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PPS Alert for Long-Term Care, Issue 10, October 1, 2009
CMS released the final rule for fiscal year (FY) 2010 payment updates to SNFs July 28, leaving many...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2009
CMS released the final rule for fiscal year (FY) 2010 payment updates to SNFs July 28, leaving many...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2009
Responsible for accurate reimbursement, long-term care billers serve as one of the most important...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2009
When it comes to billing Medicare Advantage (MA) plans, many facilities continue to struggle, often...
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MDS 3.0 Insider, Issue 25, September 7, 2009
CMS recently release an MLN Matters article outlining the instructions for billing the...
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PPS Alert for Long-Term Care, Issue 9, September 1, 2009
You may not have heard of Zone Program Integrity Contractors (ZPIC), but they will soon be...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2009
SNF business offices across the nation will soon be faced with the task of billing numerous flu...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2009
SNF billers can avoid coinsurance billing problems by identifying the payer source upon admission...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2009
Covered entities, such as nursing homes, should ensure that their BAs understand the new HIPAA...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2009
Complying with the nuances of when and how to properly submit benefits exhaust and no-pay bills...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2009
Columnist Lee A. Heinbaugh discusses how to use the OIG’s List of Excluded...
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PPS Alert for Long-Term Care, Issue 8, August 1, 2009
There is no hiding from the Recovery Audit Contractor (RAC) program, which CMS is in the process of...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2009
Columnist Lee A. Heinbaugh discusses coinsurance crossover claims and how to use the Medicare...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2009
CMS recently updated its Web site to include new FAQs about the Recovery Audit Contractor (RAC...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2009
Since the appeals process can be confusing and time-consuming, SNF billers must have a clear...
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Billing Alert for Long-Term Care, Issue 8, August 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 7, July 1, 2009
Although aspects of RUG-IV may change before implementation, SNFs should know how the proposed...
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Billing Alert for Long-Term Care, Issue 7, July 1, 2009
Although the rehab workaround may sound simple, knowing when and how to use it can be a challenge...
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Billing Alert for Long-Term Care, Issue 7, July 1, 2009
Your facility can survive a CERT review by complying with the program’s guidelines and...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2009
Columnist Lee A. Heinbaugh discusses no-pay bills and denials for speech therapy services due to...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2009
Although SNFs have been able to include V-codes on claims for years, many nursing facilities still...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2009
As economic conditions continue to decline, many SNFs are having more difficulty collecting...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2009
CMS developed ZPICs to fix flaws in the current Medicare program integrity system, which protects...
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Billing Alert for Long-Term Care, Issue 6, June 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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MDS 3.0 Insider, Issue 18, June 1, 2009
CMS officials reviewed the changes included in the latest MDS 3.0 Draft Item Set and addressed...
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Contemporary Long-Term Care Weekly, Issue 20, May 28, 2009
Senator Jay Rockefeller (D-W.Va.) recently introduced a bill that would expand the Medicare Payment...
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Contemporary Long-Term Care Weekly, Issue 19, May 21, 2009
CMS updated the frequently asked questions (FAQ) about the Recovery Audit Contractor (RAC) program...
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Contemporary Long-Term Care Weekly, Issue 18, May 7, 2009
The Centers for Medicare and Medicaid Services (CMS) released its proposed rule for FY 2010 payment...
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PPS Alert for Long-Term Care, Issue 5, May 1, 2009
Although understanding the medical review process and what fiscal intermediaries (FI) and Medicare...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2009
Enforcement of HIPAA is about to get tougher due to provisions passed under the $787 billion...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2009
Wound care supplies are excellent revenue sources, and billing your FI or MAC for these Part B...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2009
As federal spending on Medicare continues to increase, so does focus on Medicare billing errors and...
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Billing Alert for Long-Term Care, Issue 5, May 1, 2009
Columnist Lee A. Heinbaugh discusses Medicare Part A benefit periods for tube-feeding residents and...
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Contemporary Long-Term Care Weekly, Issue 16, April 23, 2009
A plan to overhaul long-term care funding could reduce federal long-term care spending by $35...
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Contemporary Long-Term Care Weekly, Issue 14, April 9, 2009
CMS posted an updated MDS 3.0 timeline on its Web site Tuesday, but apparently removed the timeline...
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Contemporary Long-Term Care Weekly, Issue 14, April 9, 2009
CMS plans to test whether financial incentives can encourage nursing facilities to make quality...
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Contemporary Long-Term Care Weekly, Issue 13, April 2, 2009
CMS will require Medicare Advantage and Medicare Part D prescription drug plan organizations to...
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PPS Alert for Long-Term Care, Issue 4, April 1, 2009
Do you think racking up therapy minutes is the only way to get a good Medicare reimbursement? If...
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PPS Alert for Long-Term Care, Issue 4, April 1, 2009
After spending billions to bail out the American banking and automobile industries, the federal...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2009
Columnist Lee A. Heinbaugh discusses managing accounts receivable and actions to take when dealing...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2009
Billing Part B ostomy, urological, and tracheostomy supplies can generate revenue for a SNF without...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2009
SNF business departments deal with billing errors on a daily basis, and although some are...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2009
Each year, the Office of Inspector General (OIG) identifies government programs under the...
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Billing Alert for Long-Term Care, Issue 4, April 1, 2009
Billing Alert for Long-Term Care provides valuable information about billing regulations...
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MDS 3.0 Insider, Issue 13, March 23, 2009
Members of the Staff Time and Resource Intensity Verification (STRIVE) project Technical Expert...
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Contemporary Long-Term Care Weekly, Issue 11, March 19, 2009
A commission that advises Congress on Medicare issues says SNFs should not receive an increase in...
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Contemporary Long-Term Care Weekly, Issue 9, March 5, 2009
SNFs must use the revised advanced beneficiary notice (ABN) form for items or services expected to...
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Billing Alert for Long-Term Care, Issue 3, March 1, 2009
Learn how to master the confusing regulations for the beneficiary notification process.
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Billing Alert for Long-Term Care, Issue 3, March 1, 2009
The incorrect calculation of therapy units has led to many Part B billing errors for SNFs, and as...
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Billing Alert for Long-Term Care, Issue 3, March 1, 2009
SNFs can bring in a considerable amount of revenue by billing Part B for parenteral and enteral...
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Billing Alert for Long-Term Care, Issue 3, March 1, 2009
This issue of Billing Alert for Long-Term Care covers Part B billing for parenteral and enteral...
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Contemporary Long-Term Care Weekly, Issue 8, February 26, 2009
On February 20, CMS released the Advance Notice of policy and technical changes to be made to the...
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Contemporary Long-Term Care Weekly, Issue 6, February 12, 2009
CMS seeks comments on a proposed 60-day delay in the effective date of the Interim Final Rule for...
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Contemporary Long-Term Care Weekly, Issue 6, February 12, 2009
Unsuccessful bidders withdrew their protests to the recovery audit contractor (RAC) program on...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2009
To ensure a smooth transition from FIs to MACs, SNF billers must stay informed, complete the...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2009
Although the proposed implementation date for the ICD-10-CM is not until 2013, SNF billers need to...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2009
As the United States endures the worst economic crisis since the 1930s, the healthcare industry...
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Billing Alert for Long-Term Care, Issue 2, February 1, 2009
No one is safe from the effects of the global economic crisis, but SNFs can minimize the financial...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2009
The transition to the Medicare Prescription Drug Program, known as Medicare Part D, was difficult...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2009
This issue of Billing Alert for Long-Term Care covers benefits exhaust and no-pay claims, how to...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2009
Facility business departments must be aware of when they are responsible for billing for hospice...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2009
Benefits exhaust and no-pay bills continue to create problems for SNFs, and, this year, improper...
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Billing Alert for Long-Term Care, Issue 1, January 1, 2009
Columnist Lee A. Heinbaugh discusses common Medicare Part A billing issues.
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Billing Alert for Long-Term Care, Issue 12, December 1, 2008
This issue of Billing Alert for Long-Term Care covers how to use roster billing for immunizations...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2008
Billers can help to better prepare their SNFs for the expanding RAC program by enacting prevention...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2008
Roster billing can help your billing department cut down on the time it takes to process...
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Billing Alert for Long-Term Care, Issue 12, December 1, 2008
To avoid problems with billing for ambulance services, medical billers must understand the rules...
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Contemporary Long-Term Care Weekly, Issue 48, November 20, 2008
Paying for medications in your facility is a complicated and expensive process. There are a...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2008
Many SNFs do a poor job of maintaining their census report, and this can create issues with...
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Billing Alert for Long-Term Care, Issue 11, November 1, 2008
Columnist Lee A. Heinbaugh answers questions about billing for wound care.
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Billing Alert for Long-Term Care, Issue 11, November 1, 2008
A recent CMS transmittal shines the spotlight on an often-overlooked UB-04 coding element: the...
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Billing Alert for Long-Term Care, Issue 11, October 10, 2008
State Medicaid programs require Medicaid beneficiaries to contribute a resident resource...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2008
Effective April 30, 2007, fiscal intermediaries and Part A/B Medicare administrative contractors...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2008
Columnist Lee A. Heinbaugh discusses appropriate assessment types and Medicare Part A billing.
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Billing Alert for Long-Term Care, Issue 10, October 1, 2008
SNFs now have some up-to-date directions when it comes to billing Medicare for bed holds.
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Billing Alert for Long-Term Care, Issue 10, October 1, 2008
The skilled nursing facility (SNF) PPS and consolidated billing final rule for fiscal year 2009...
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Billing Alert for Long-Term Care, Issue 10, October 1, 2008
CMS clarifies when SNFs can bill the Medicare Part A default rate if a PPS MDS assessment...
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Billing Alert for Long-Term Care, Issue 9, September 1, 2008
Columnist Lee A. Heinbaugh answers questions about Medicare Advantage claims.
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Billing Alert for Long-Term Care, Issue 9, September 1, 2008
Medicare coinsurance collections can often trip up billers. To ensure productive, timely Medicare...
