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Case study: Challenges facing SNF Medicare billers

May 16, 2019
The Bottom Line

Communication disconnects between the biller and other departments happen frequently. Billers do not always receive information that affects compliant billing. This may be due to fragmentization of departments, lack of meaningful Medicare utilization systems, differences in software (e.g., MDS vs. billing) that are not interoperable, or an unawareness from the interdisciplinary team (IDT) as to the importance of billers in the Medicare reimbursement process.

May 30 deadline for reviewing provider preview reports

May 16, 2019
The Bottom Line

SNF Provider Preview Reports are available during a 30-calendar day preview period beginning from the date on which providers can access the report. SNF providers have until May 30, 2019 to review reports that contain data submitted between 2017 Quarter 4 and 2018 Quarter 3 for assessment-based quality measures, and between 2017 Quarter 1 to 2017 Quarter 4 for claims-based quality measures.

Breaking down common SNF form locator codes

May 16, 2019
Billing Alert for Long-Term Care

The UB-04 is made up of form locators (FL), or boxes to be completed. Some of the FLs are required, some are optional, and some are not used in the SNF setting. If any required pieces are missing, the claim will not pass the system edits when it is submitted to the MAC. Although most Medicare billing is done electronically and the UB-04 is completed largely by the billing software, it is important for Medicare billers to be familiar with the pieces of information required on the claim and how to complete the form.


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