Requirements For SNF Consolidated Billing (CB)

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Requirements For SNF Consolidated Billing
(CB)
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Requirements For SNF Consolidated Billing
(CB)
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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SNF Billing Issues
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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Requirements for Consolidated Billing For SNF
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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Why Outsource SNF Billing and Coding?
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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About Us
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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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Contact Us
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Services Georgia 3001 Greenfield Drive, Marietta
GA 30068 Ohio 28405 Osborn Road, Cleveland, OH
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Austin TX, 78741 Delaware 16192 Coastal Highway,
Lewes, Delaware 19958, United States Phone no /
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