Category: Billing

AHCA finds long-term care services underfunded by Medicaid

The American Health Care Association (AHCA) released a report today demonstrating that the long term care services are significantly underfunded by Medicaid. The report estimates that the nation will have the highest Medicaid shortfall on record for 2013—over 7.7 billion dollars. On a daily basis, the shortfall is $24.26 per Medicaid patient. This shortfall is […]

Overpayments resulting from improper claims for ambulance services

On November 6, the Centers for Medicare & Medicaid Services (CMS) released Transmittal 1311, which offered guidance on the contractor claim data, identified by suppliers, which were billing ambulance claims for SNF to SNF transfer separately under Part B. This was resulting in overpayments. As a result of overpayment for a transport between two SNFs […]

CMS issues ICD-10 split claims billing instructions

CMS issued a MLN Matters article that offers instructions that clarify the policy for processing claims for certain institutional encounters that span the ICD-10 implementation date of October 1, 2014. Skilled Nursing Facilities (Inpatient Part B): Bill type: 22X Use FROM date Require providers split the claim so all ICD-9 codes remain on one claim […]