Medicare Guide for SNF Billing and Reimbursement, Third Edition

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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

  • Table of Contents

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