This March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries mThis March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries must have been categorized as being an inpatient in a hospital for three midnights in order to qualify for a Medicare Part A SNF stay.
The Billers' Association for Long-Term Care is now the Association for Medicare Billing and Reimbursement (AMBR) for Long-Term Care! This new name better represents all that our association stands for and our mission to serve as a national resource for long-term care billing and reimbursement professionals and provide a community for networking, education, and analysis of complex regulations to empower its members to succeed and achieve professional growth.
If you haven’t visited the association's webinar library recently, you may want to pay it a visit. You can sign up for our upcoming shows, which are available on a quarterly basis, or watch the on-demand version of the ones you missed.
The Billers’ Association advisory board is a group of professionals who provide expertise and an industry voice for members and the wider long-term care billing profession. Their role is to provide long-term care billing best practice guidance while serving The Billers’ Association and the billing profession with honor and integrity. We want to grow our board and welcome you to apply!
The UB-04 is a multipurpose claim form used for all Medicare providers, including home health agencies and hospitals, but not all fields apply to SNFs. SNFs must submit bills in sequence for each beneficiary they care for. Out-of-sequence bills will result in an error message similar to this: Bills for a continuous stay or admission must be submitted in the same sequence in which services are furnished. If the provider has not already done so, please submit the prior bill. Then, resubmit this bill after you receive the remittance advice for the prior bill. Billers for SNFs must understand the bill types and their codes to submit them in the correct sequence.
CMS announces that starting in March, the Quality Improvement and Evaluation System (QIES), Certification and Survey Provider Enhanced Reports (CASPER) and Automated Survey Processing Environment (ASPEN) will undergo a series of modernizing enhancements. The agency clarified that once updated, the new system, Internet Quality Improvement and Evaluation System (iQIES), will not change how providers currently submit data to CMS.