Description
The Medicare Billing Manual for Long-Term Care Conquer no-pay bills, exhaust billing, and ensure proper reimbursement under RUG-IV
The Medicare Billing Manual for Long-Term Care 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 Medicare Billing Manual for Long-Term Care will help you:
- Understand and comply with the billing changes under RUG-IV
- Correctly file monthly, no-pay, and benefits exhaust claims
- Complete the UB-04 accurately
- Apply expert insight and insider tips to your SNF consolidated billing
- Understand which ancillary services are covered under Part B
- Increase cash flow and financial viability with Part B billing
- Avoid auditor scrutiny by correctly submitting claims to Medicare on the first try
Chapter 1: Overview and History of the Medicare Program
Chapter 2: Part A SNF Billing
Chapter 3: Billing for Ancillary Revenue
Chapter 4: Part B Outpatient Therapy Services and Billing
Chapter 5: Billing for DMEPOS
Chapter 6: Billing for Diagnostic Tests, Lab Services, and Radiology
Chapter 7: Billing for Screening and Prevention
Chapter 8: Ensuring a Solid SNF Billing System
Appendix A: Acronyms
Appendix B: Forms
ToolsWhen 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
About the Author
Frosini Rubertino, RN, C-NE, CDONA/LTC, CPRA, is a regulatory specialist with more than 25 years of healthcare experience. She has trained and advised long-term care staff on how to achieve compliance and maintain excellence in their respective roles.As the executive director of TrainingInMotion.org, Rubertino is a nationally recognized regulatory specialist and instructor for HCPro's Survey Prep Boot Campsm and Medicare Boot Camp(R)--Long-Term Care Version. She is the author of HCPro's The QIS Mock Survey Guide, is a member of the editorial advisory board for HCPro's Billing Alert for Long-Term Care, and has contributed to numerous published articles related to PPS and Medicare billing.