Do you know about the requirements for SNF Consolidated Billing (CB)?We will take care of consolidate billing for skilled nursing facilities.
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Skilled Nursing Facility (SNF) differs from nursing homes, so their
services are also different. Many confuse the two, but nursing homes
can have experienced nurses who do not require professional care like
SNFs, which marks the difference between the two. In most cases, the
care provided by SNF is by occupational therapists, physical therapists,
speech-language pathologists, and common and licensed practical
nurses. Though the list is not exclusive, patients in SNFs that are part of
the Medicare practice can be admitted to skilled nursing residents in
several cases. Thereby, the billing process resulted in problems that
were eventually rectified with the SNF consolidated billing (CB).
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The confusion between nursing homes and SNF often results in claim
rejection and denials. In the Balanced Budget Act of 1997, Congress
mandated that most nursing services be provided under the SNF in
the potential payment bundle. The bundle was to be paid through
Part A of MAC (Medicare Administrative Contractor).
Hence, the SNF can furnish services covered in Part A in the
consolidated billing (CB). In fact, it can be done by using the
resources of the SNF directly, transfer agreement with the SNF, or
with a particular therapist as agreed by the SNF.
• There could be duplication of bills when both SNF and the
supplier billed for the same services
• Beneficiaries often incurred the out-out-pocket liability for the
deductible of Part B despite the supplier billing the insurer for that.
• The residents’ quality of care was adversely affected when
different outside care suppliers were brought into the program.
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The Balanced Budget Act of 1997 (BBA), Public Law 105-33, Section
4432(b), was enacted by Congress, and it required the SNF to
undertake Consolidated Billing (CB). Under this enactment, the SNF had
to submit the claims provided to the residents to Medicare. The only
services that could be exempted were the ones that were not listed.
CB ensures no duplication of the billing while meeting the responsibilities
it has towards the patients. But there are certain exceptions, which are
excluded from the CB. Hence the billing can be done separately.
However, many facilities and their admin staff find managing the SNF
consolidated billing process challenging. It often leads to revenue loss
and, worst case scenario, getting investigated by the authorities and
fined for wrong billing and coding. All these problems can be quickly
resolved with the help of an expert partner like 24/7 Medical Billing
Services.
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The experts of 24/7 Medical Billing Services in SNF consolidated billing
are equipped with the latest guidelines and knowledge of the CB in
Skilled Nursing Facilities. They also have the necessary EHR software
to manage SNF consolidated billing. The EHR software can process
high-volume data, including coverage of the residents and the payer
plans.
Apart from such software, the trained staff understands the importance
of proper coding, which is required in Consolidate Billing for skilled
nursing facilities. Hence by working with the experts, any SNF can get
the best-streamlined billing and coding process. It eventually ensures
every bill is claimed on time, no delays in A/R, and no claim denials,
rejections, and issues with reimbursement of the services. In the long
run, the admin can put in place a better revenue management cycle for
the SNF by adhering to the CB guidelines and warranting a better ROI
for the facility.
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We are a medical billing company that offers ‘24/7 Medical Billing
Services’ and support physicians, hospitals, medical institutions and
group practices with our end to end medical billing solutions. We help
you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow
physicians to attract additional revenue and reduce administrative
burden or losses.
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