Medicare Compliance & Reimbursement

Target underbilling in these key scenarios. Skilled nursing facilities looking for new ways to reduce rehospitalization and get more physician coverage for their patients might ensure their attendings understand how to get paid appropriately for services provided in their facilities. Geriatricians and internists who provide services to nursing home patients may also benefit from brushing up on correct coding and billing. The reality: SNF patients come from hospitals and most are fairly sick with lots of clinical problems, observes Charles Crecelius, MD, PhD, CMD, a nursing home medical director and health policy advisor for the American Medical Directors Association. And if you treat the patients aggressively, they will return to a lower level of care more quickly, which is cost effective and part of practicing "value-based medicine," he adds. Using that approach, physicians earn more money by "doing the job right, improving care -- and also saving society money," says Crecelius. [...]