HCPro.com: Billing Alert for Long-Term Care

It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility deserves. Billing Alert for Long-Term Care provides the crucial tips and strategies that billers need for success.

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September 2008 (Volume 10, Issue 9)	view entire issue

Prepare for a personal funds review during survey
The new quality indicator survey (QIS) process is slowly picking up speed. Statewide rollout is already underway in Connecticut, Florida, Louisiana, Kansas, Minnesota, and Ohio, and CMS has selected three additional states (reportedly North Carolina, New Mexico, and West Virginia) to begin the transition to the QIS in the near future. However, facilities that aren't facing imminent QIS implementation can benefit from the tools developed for this new survey process. This is because these tools are based on current federal regulation and interpretive guidance to surveyors used in traditional surveys, says Mary Leber, RN-BC, RA-C, director of consulting services at Ecumen, a nonprofit senior housing company in Shoreview, MN.

Six steps to better Medicare coinsurance billing
Medicare coinsurance collections can often trip up billers. To ensure productive, timely Medicare coinsurance billing, follow these steps: 1. Don't assume that a new resident has only one payer. Many facilities fail to define the payer source after Medicare during the admissions process, says Mary Petersen, NHA, health services consultant at Specialized Medical Services, Inc., in Milwaukee. "Anyone who comes into a facility has to have at least two payers. A resident is either Medicare and private pay, Medicare and pending Medicaid, or Medicare and insurance [and subsequently private pay]. Providers must check the benefits in order to define the payer source," Petersen says.

BALTC Q&A
Editor's note: "Q&A" was written by Lee A. Heinbaugh, president of The Heinbaugh Group, a long-term care consulting company in Lakewood, OH. To submit questions, e-mail Associate Editor Emily Beaver at ebeaver@hcpro.com.

Other recently-published articles from Billing Alert for Long-Term Care:

Hospice services: Know when and how your facility should bill

Benefits exhaust and no-pay bills

BALTC Q&A

Medicare Part D: SNFs, LTCPs, and dual-eligible residents

Recovery audit contractors: Ready or not, here they come

Take the pain out of immunizations with roster billing

Billing for ambulance services: Combat common problems and reduce costs for your facility

BALTC Q&A

Rein in the facility census

Coding patient status on the UB-04

BALTC Q&A

Don’t overlook condition codes

Don’t let your billing office bypass resident resource payments

How FIs view changes in therapy services during a payment period

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