Tag: billing

Special requirements for billing urology supplies & updated DMEPOS fee schedule

Source: The Bottom Line Medicare covers urinary catheters and external urinary collection devices when they are used to drain or collect urine for a resident with permanent urinary incontinence or permanent urinary retention. According to CMS, permanent urinary retention occurs when the condition is not expected to be medically or surgically corrected within three months. […]

CMS releases updates to billing for flu vaccine

by The Bottom Line Flu season is August to April. Make sure you’re prepared to start billing for the influenza virus vaccine by staying up to date on the latest code and payment allowance updates. So far, CMS has released the following two notices: 1. Payment allowances for the influenza virus vaccine are updated on […]

Avoid Medicaid payment delays by being proactive

Written by Becky Ziviski, CPA, LNHA, speaker and author of Profit Without Census: A Nursing Home Administrator’s Guide to Profitability by Department. Editor’s note: This post is an excerpt taken from the full article originally published in the August issue of PPS Alert for Long-Term Care. A delay in the application process for Medicaid can […]

CMS scrutiny of updates to Part B therapy coding to begin January 2018

In a recent MLN Matters article, the Centers for Medicare & Medicaid Services (CMS) published revisions to editing of Part B “Always Therapy” services, identifying outpatient therapy (OPT) services that must always be accompanied by a discipline-specific therapy modifier. CMS states that Change Request (CR) 10176, intended for therapists, physicians, and certain other practitioners billing […]

Home health device provider to pay for improper billing

Apria Healthcare, which makes home healthcare devices, has been ordered to pay $750,000 to resolve obligations that they billed patients that were already covered by MassHealth, Massachusetts’ state insurance program. The State Attorney General’s office told WWLP.com that between December of 2011 and April of 2017, some 1,000 MassHealth members were inappropriately billed, and of […]

In the end, even the middle class would feel GOP cuts to nursing home care

By Jordan Rau, Kaiser Health News ORANGE, Va. — Alice Jacobs, 90, once owned a factory and horses. She raised four children and buried two husbands. But years in an assisted living facility drained her savings, and now she relies on Medicaid to pay for her care at Dogwood Village, a nonprofit, county-owned nursing home […]

CMS welcomes feedback on proposed case-mix rule, extends comment deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the comment deadline for the advance notice of proposed revisions to case-mix methodology rule from June 26, 2017 to August 25, 2017. The advance notice of proposed rulemaking, titled “Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology,” was published […]

NEW: Billing boot camp for SNFs

HCPro’s new Skilled Nursing Facility Billing Boot Camp covers the latest Medicare billing rules and regulations so that you can help your facility bill appropriately for services and prevent payment denials. The bootcamp will be held Monday, August 14 – Tuesday, August 15, from 8:00 a.m. – 5:00 p.m. Skilled Nursing Facility Billing Boot Camp provides […]

Cardiac and orthopedic bundled payment models delayed to Jan 1, 2018

In a final rule published in the Federal Register today, May 19, the Department of Health and Human Services (HHS) finalized May 20, 2017 as the effective date of the bundled payment models and changes to the Comprehensive Care for Joint Replacement Model and delayed the implementation date of the final rule to January 1, […]

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 […]