Medicare Guide for SNF Billing and Reimbursement, Third Edition

Long-term care billers play a vital role in ensuring proper reimbursement for their facility-but that role is not easy. Billers need to ensure they are not leaving money on the table these days. The Medicare Guide for SNF Billing and Reimbursement, Third Edition will help you tackle the newest and most complex billing issues..

This guide is updated to reflect the FY 2021 final payment rule, and of course, includes all Patient-Driven Payment Model changes from 2019. Offering tables, charts, and tools outlining both case-mix and non-case-mix components that will form SNFs' rates, this book is the perfect referral resource to make sure you and your staff are filing clean claims..

In addition to billing for services covered under Medicare Parts A/B and PDPM, this book addresses:

No-pay bills

Filling out the UB-04

SNF consolidated billing

Part B outpatient therapy services and billing

Billing for medical supplies

Billing for diagnostic tests, lab services, and radiology

Billing for screening and prevention

ICD-10 coding, including updates to PDPM clinical diagnosis mapping for 2021

Disaster-related billing, including COVID-19 waivers


This book will help billing staff:

Understand new changes under the FY 2021 payment rule

Identify opportunities to maximize reimbursement and accurately project revenue

Correctly bill for Medicare Part A and Part B claims

Understand how to comply with claims submissions and avoid common billing errors

Navigate difficult reimbursement scenarios

Effectively communicate with other departments to manage reimbursement and proper documentation

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