Skilled Nursing Facility Billing Boot Camp

Course Overview

HCPro's Skilled Nursing Facility Billing Boot Camp covers the latest Medicare billing rules and regulations so that you can help your facility bill appropriately for services and prevent payment denials.

Skilled Nursing Facility Billing Boot Camp provides hands-on, how-to education focusing on billing for Medicare Part A and B, the ins and outs of PDPM, consolidated billing, and accurately completing the UB-04. Plus, guidance on understanding the SNF coverage criteria and a breakdown of the different beneficiary notices.

Attendees will be able to return to their facility with the tools they need to understand the latest billing and reimbursement regulations, plus how to navigate the many billing processes to ensure their SNF is receiving appropriate reimbursement for services provided.

Looking to train your whole team? We can bring our expert instructors to you! Learn more here!

Skilled Nursing Facility Billing Boot Camp

Course Outline/Agenda

DAY 1
Module 1: Intro to SNF Medicare

• Medicare A, B, C, and D
• Medicare administrative agencies
• Spell of illness/benefit periods
• SNF eligibility criteria
• Verification of benefits

Module 2: Medicare Coverage

• Coverage basics
• Physician certification and recertification
• Documentation requirement basics
• Beneficiary notices

Module 3: Part A Billing

• SNF PPS - Patient Driven Payment Model (DPDPM) overview
• The impact of quality on reimbursement (SNFQRP and SNFVBP)
• Completing the UB-04 for Part A
• The relationship between the claim and documentation
• Linking the MDS to reimbursement

Module 4: Special Part A Billing Scenarios

• No pay claims
• Benefits exhaust claims
• LOA claims
• Medicare C agreements, preadmission screening, and billing
• Medicare as a secondary payor

DAY 2
Module 5: Part B Billing

• Completing the UB-04 for Part B
• Therapy caps
• Multiple Procedure Payment Reduction (MPPR)
• Applying modifiers
• Ancillary billing

Module 6: Consolidated Billing

• Five major categories of consolidated billing
• Medicare allowable amounts
• Drug exclusions
• Tools and resources

Module 7: Tying It All Together

• Admissions packet checklist
• PEPPER reports
• Medical review and appeals
• Compliance & ethics program
• Triple check

*Please Note: Agenda is subject to change.

Skilled Nursing Facility Billing Boot Camp

Learning Objectives

• Locate key Medicare sources of authority so that you can find answers to your Medicare questions
• Identify the eligibility criteria for a SNF Part A admission
• List the technical criteria for a SNF Part A admission
• Determine best practices for SNF Part A admissions
• Understand the required coding for Part B therapy claims
• Understand how to resolve discrepancies between documentation and claims
• Accurately complete the UB-04
• Describe the scenarios for the appropriate use of beneficiary notices
• Identify potential items and services subject to consolidated billing
• Understand the political landscape and evolving payment reform
• Understand how payment is assigned under PDPM
• Understand the different types of medical reviewers and claims audits
• Learn how to conduct an efficient and effective triple check

Skilled Nursing Facility Billing Boot Camp

About Your Presenter

Reta A. Underwood, RAC-CT, C-NM, QCP, CPC 

Reta A. Underwood, RAC-CT, C-NM, QCP, CPC, has more than 34 years of professional work experience in the long-term care industry. Her experience includes management and director positions with nursing facilities and healthcare companies. She has also provided corporate-wide MDS support services, numerous mock surveys, regulatory compliance correction, educational programs, clinical documentation, quality assurance programming, and most recently implemented PDPM in facilities nationwide.

Underwood has supplied input to CMS and has been included on projects and discussions pertaining to post-acute care. She holds national certifications through the American Association of Nurse Assessment Coordination (AANAC) as a Resident Assessment Coordinator (RAC-CT); Quality (QAPI) Professional and Nurse Manager and is an ICD-10-CM coder.

Skilled Nursing Facility Billing Boot Camp

Questions/Answers

What is the focus of the Skilled Nursing Facility Billing Boot Camp? 
HCPro's Skilled Nursing Facility Billing Boot Camp covers the latest Medicare billing rules and regulations so that you can help your facility bill appropriately for services and prevent payment denials. This two day course provides hands-on, how-to education focusing on billing for Medicare Part A and B, the ins and outs of consolidated billing, accurately completing the UB-04. Plus, guidance on understanding the SNF coverage criteria and a breakdown of the different beneficiary notices.

Where is the course offered? 
Open registration courses are offered at various locations around the country, typically at mid-priced business hotels, such as the Hyatt Place or Hilton Garden Inn. For a current schedule of upcoming open registration courses, click on "Locations/Dates" above.

Does HCPro offer this course on-site? 
In addition to our open registration courses, we also offer the Skilled Nursing Facility Billing Boot Camp as an on-site course (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site course at your facility/offices, click on Host an On-Site Course.

What if I need to cancel or transfer my registration? 
Cancellation Policy 
Please click here to view our cancellation policy.

Who should attend this course? 

• Business office manager 
• Business office staff 
• Billers 
• Billing Director 
• Accounting Director 
• Accounting staff 
• CFO 
• Administrators/Owners/Executive Directors 
• Reimbursement Specialists 

What do I need to know prior to attending?
Please read further with our Get Ready for Class outline.

What material does the course cover?
To view the course outline, click on "Course Outline" above. 

How is the course taught?
The course is taught using a combination of lecture, class discussion, and hands-on exercises/case studies. 

What do I need to bring to class? 
When you arrive at class, you will receive an extensive notebook of course materials. These manuals will contain all the materials needed for the training. Please ensure room in your luggage for the return trip.

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies? 
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information?
Contact our sales team at 615-724-7200 or email PD-IS@SimplifyCompliance.com.