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Practical Guide to Hospitalist Recruitment and Retention Conquer no-pay bills, exhaust billing, and ensure proper reimbursement under RUG-IV The Complete Guide to Long-Term Care Medicare Billing provides easy-to-understand guidance to help long-term care facilities correctly file Medicare Part A and Part B claims. It breaks down the often misunderstood consolidated billing process, clarifies the appropriate use of beneficiary notices, and offers practical solutions for billing under RUG-IV. The Complete Guide to Long-Term Care Medicare Billing will help you: • Understand and comply with the billing changes under RUG-IV • Correctly file no-pay bills and benefits exhaust claims • Complete the UB-04 accurately • Apply expert insight and insider tips to your SNF consolidated billing • Correctly complete and file Medicare Part A and Part B claims Table of Contents Section I: Medicare Part A SNF services • Overview of Medicare Part A • Eligibility and enrollment - Eligibility verification - Enrollment - Cost • Technical criteria - Coverage - Benefit periods - Beneficiary notices - Physician certification and recertification • Billing - CMS 1450 (UB-04) - Types of bills - Timely filing guidelines • Consolidated billing - Major Categories - Communication for accurate billing • Reimbursement - RUG IV - MDS 3.0 Section II: Medicare Part B SNF services • Overview of Medicare Part B • Eligibility and enrollment - Eligibility verification - Enrollment - Cost • Technical criteria - Coverage - Benefit periods - Beneficiary notices - Physician certification and recertification • Billing Part B - CMS 1500 - Timely filing requirements • Part B Major Categories of billable services • Reimbursement • Section III: Ensuring a solid SNF billing system • Communication • Internal compliance systems - Triple check • Billing system challenges Tools When you purchase this book, you will also receive on-line access to a number of valuable tools, which you can download straight to your desktop, then customize to fit your specific needs. Among the tools available include:. • RUG-IV classification chart (shows the breakdown of RUG-IV classification) • RUG spider chart • RUG grouper criteria chart • ADL calculation chart • UB-04 top sections that reveal code changes |
