Category: Billing

Understand special SNF billing cases to avoid claims rejections

Editorial Note: This post is an excerpt from HCPro’s title Consolidated Billing for Long-Term Care by Frosini Rubertino, RN, BSN, C-NE, CDONA/LTC Often times, claim rejections and negative outcomes from billing compliance audits are results of ineffective or nonexhaustive billing processes within the skilled nursing facility (SNF). The below information will help providers lay the […]

Quality Payment Program short training videos now available

The Centers for Medicare & Medicaid Services (CMS) have created a number of new, self-paced educational videos that are now available on YouTube (Go.cms.gov/QPPvideos) and the agency’s Events page. These videos help to explain aspects of the Quality Payment Program in approximately 10 minutes or less. The agency believes stakeholders will greatly benefit from this […]

GAO finds improved oversight of state Medicaid payment structures needed in MLTSS

In two January 2017 reports filed by Government Accountability Office (GAO), the agency found that: CMS’ oversight of state payment structure regarding Medicaid funding was limited. Data collected from the Centers for Medicare & Medicaid Services’ (CMS) systems used to describe the distribution of and spending on Medicaid personal care services is limited due to […]

Last chance to join your colleagues in Nashville!

Skilled Nursing Facility Volume- to Value-Based Reimbursement Boot Camp is in Nashville, TN, March 13-14. Building solid operational and clinical processes is key for skilled nursing facilities (SNF) to stay compliant under the numerous Centers for Medicare & Medicaid Services (CMS) regulatory changes effective October 1. The evolving “volume to value” industry landscape brings with […]

Congratulations to our AHCA convention winners!

Like many of you, HCPro attended the AHCA/NCAL 63rd Annual Convention & Expo last month. We had a great time chatting with you about your education and training needs. We’d like to thank you for stopping by the booth! We entered many of you into a raffle–well, it’s time to announce our raffle winners! Cheryl […]

Upcoming webcast: Medicare Part B: Get the Most Out of Your SNF Reimbursement

Join us tomorrow for this Medicare Part B webcast. Expert speaker, Janet Potter, from Marcum, LLP will help you understand the many requirements for billing Medicare Part B, including what items can be billed by the SNF and how to maximize reimbursement for your facility. Questions and issues will arise regarding claim discrepancies, and you’ll need to […]

The final rule and MDS/RAI changes are here. Are you ready?

The long-awaited final rule on the revised/new SNF Conditions of Participation has been published in the Federal Register. The public inspection version is available now, including the comments from the Proposed Rule. The final rule will revise the requirements that long-term care facilities must meet to participate in the Medicare and Medicaid programs. The effective […]

Physicians and health care providers continue to improve quality of care, lower costs

Affordable Care Act Accountable Care Organization initiatives put patients at the center of their care while generating more than $1.29 billion in total Medicare savings since 2012. The Centers for Medicare & Medicaid Services (CMS) announced on August 25, 2016, the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable […]

Join us for a Skilled Nursing Facility Volume- to Value-Based Reimbursement Boot Camp!

Join us on 10/10/16 – 10/11/16 in Davidson (Charlotte), NC Building solid operational and clinical processes is key for skilled nursing facilities (SNF) to stay compliant under the numerous Centers for Medicare & Medicaid Services (CMS) regulatory changes effective October 1. The evolving “volume to value” industry landscape brings with it more accountability, higher outcome […]

Digital Standards and Operating Rules adopted by HHS under HIPAA

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required HHS to establish digital standards for business-related tasks like submitting claims and getting paid. The goal is to reduce paperwork and streamline business processes across the health care system. Standards allow information to be shared digitally in consistent ways. With common standards for content […]