Consolidated Billing for SNFs: A Close Look at the Five Major Categories
Wednesday, May 31, 2017
1:00-2:30 p.m. Eastern
Janet Potter, CPA, MAS, Senior Manager, Advisory Services, Marcum LLP
Level of Program:
A thorough understanding of how consolidated billing works will help billing and administrative staff determine which residents are subject to consolidated billing when there is a leave of absence, pay the correct vendor invoices, communicate efficiently with other vendors and physicians, and determine the Medicare allowable amount for services provided by outside vendors.
During this 90-minute program, expert speaker Janet Potter, CPA, MAS, senior manager for Marcum, LLP, will dive into the five major categories of SNF consolidated billing and define the difference between inclusions and exclusions. She will also explain how payment for services performed outside the SNF can be affected by consolidated billing, which items and services may be subject to consolidated billing, and how staff members can avoid extra costs for the SNF by recognizing opportunities for Part B billing.
At the conclusion of this program, participants will be able to:
- Explain consolidated billing issues to residents and families
- Identify potential items and services subject to consolidated billing
- Know why it is important to review what services a Part A resident is receiving off-site prior to the services being performed
- Know the questions to ask to determine whether chemotherapy and other services will be excluded from the Part A PPS per diem
- Recognize why the same service performed in a different location might be payable by the SNF
Who Should Listen?
- Social workers
- Business office staff
- The five major categories of SNF consolidated billing:
- Exclusion of Services Beyond the Scope of a SNF
- Additional Services Excluded when Rendered to Specific Beneficiaries
- Additional Excluded Services Rendered by Certified Providers
- Additional Excluded Preventive and Screening Services
- Part B Services Included in SNF Consolidated Billing
- Difference between inclusions and exclusions
- Determining when chemotherapy drugs are included in the SNF PPS payment
- Understanding how payment for services performed outside the SNF can be affected by consolidated billing
- Understanding which items and services may be subject to consolidated billing
- CMS five categories of consolidated billing
- Sample tracking sheet
- Sample notification letters
Meet the Speaker
Janet Potter, CPA, MAS, is a senior manager in the healthcare advisory group at Marcum LLP. Potter joined Marcum through the firm´s 2015 merger with Frost, Ruttenberg, & Rothblatt PC (FR&R Healthcare Consulting, Inc.). She delves into numerous aspects of the healthcare industry, including Medicare and Medicaid billing, compliance issues, and changing regulations for skilled nursing facilities.
Potter writes and prepares articles, speaker presentations, and seminar materials, as well as monitoring industry websites for regulatory and compliance changes. She is a frequent speaker on various topics affecting long-term care. Potter is a member of the Advisory Board for HCPro's Billers' Association for Long-Term Care and frequently contributes to PPS Alert for Long-Term Care and other HCPro publications.
Webinar system requirements and program materials:
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