In Billing
Dec 13th, 2017
In case you were unaware of proper billing of services for Medicare patients in a covered Part A inpatient stay, here is a refresher. Medicare will not pay acute-care hospitals for outpatient services provided to patients in a covered Part A inpatient stay at another facility. This includes Medicare patients who are inpatients of long-term ...
In CMS
Oct 18th, 2016
Transitioning a loved one into a long-term care facility isn’t an easy decision. The patient’s family wants to ensure their loved one receives the highest quality care. The Centers for Medicare & Medicaid Services (CMS) knows this, and has issued a final rule to help improve the care and safety of approximately 1.5 million Medicare & ...
In Audit
Jan 27th, 2016
CenterLight Health Care, formerly Beth Abraham Family of Health Services, has agreed to repay a combined $47 million to state and federal authorities after admitting to having over 1,000 ineligible members in its Medicaid-sponsored long term care plan. The Medicaid-funded care plan required that the members be in need of nursing home care to qualify. ...
Aug 3rd, 2015
The Centers for Medicare & Medicaid Services (CMS) released a final rule for 2016 skilled nursing facility (SNF) payments, which follows the shift of rates to be based on value and quality of care, rather than volume. According to CMS’ July 30, 2015 Fact Sheet, highlights of the final rule (CMS-1622-F) are: CMS projects that aggregate payments in FY ...
In Billing
Sep 12th, 2014
The Centers for Medicare & Medicaid Services (CMS) Change Request (CR) 8877 updated Medicare hospice manual instructions for acceptable principal diagnosis codes and timely filing of Notice of Election (NOE), as well as coding guidance for skilled versus non-skilled nursing facilities. Changes are effective October 1. Hospice Principal Diagnosis Coding Guidance The coding instructions in ...