Skilled Nursing Facility Billing Boot Camp
About this Event
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Course Overview
HCPro's 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.
Skilled Nursing Facility Billing Boot Camp provides hands-on, how-to education focusing on billing for Medicare Part A and B, the ins and outs of PDPM, consolidated billing, and accurately completing the UB-04. Plus, guidance on understanding the SNF coverage criteria and a breakdown of the different beneficiary notices.
Attendees will be able to return to their facility with the tools they need to understand the latest billing and reimbursement regulations, plus how to navigate the many billing processes to ensure their SNF is receiving appropriate reimbursement for services provided.
Learning Objectives
Locate key Medicare sources of authority so that you can find answers to your Medicare questions
Identify the eligibility criteria for a SNF Part A admission
List the technical criteria for a SNF Part A admission
Determine best practices for SNF Part A admissions
Understand the required coding for Part B therapy claims
Understand how to resolve discrepancies between documentation and claims
Accurately complete the UB-04
Describe the scenarios for the appropriate use of beneficiary notices
Identify potential items and services subject to consolidated billing
Understand the political landscape and evolving payment reform
Understand how payment is assigned under PDPM
Understand the different types of medical reviewers and claims audits
Learn how to conduct an efficient and effective triple check
Course Outline/Agenda
DAY 1
Module 1: Intro to SNF Medicare
Medicare A, B, C, and D
Medicare administrative agencies
Spell of illness/benefit periods
SNF eligibility criteria
Verification of benefits
Module 2: Medicare Coverage
Coverage basics
Physician certification and recertification
Documentation requirement basics
Beneficiary notices
Module 3: Part A Billing
SNF PPS - Patient Driven Payment Model (DPDPM) overview
The impact of quality on reimbursement (SNFQRP and SNFVBP)
Completing the UB-04 for Part A
The relationship between the claim and documentation
Linking the MDS to reimbursement
Module 4: Special Part A Billing Scenarios
No pay claims
Benefits exhaust claims
LOA claims
Medicare C agreements, preadmission screening, and billing
Medicare as a secondary payor
DAY 2
Module 5: Part B Billing
Completing the UB-04 for Part B
Therapy caps
Multiple Procedure Payment Reduction (MPPR)
Applying modifiers
Ancillary billing
Module 6: Consolidated Billing
Five major categories of consolidated billing
Medicare allowable amounts
Drug exclusions
Tools and resources
Module 7: Tying It All Together
Admissions packet checklist
PEPPER reports
Medical review and appeals
Compliance & ethics program
Triple check
*Please Note: Agenda is subject to change.
Speaker
Coming Soon!