I just happened to see this old post with no replies. I am in orthopedics and have been dealing with this SNF issue for years. I have developed a system which has greatly helped. Asking Medicare patients if they are enrolled in a SNF does help, but is not 100% effective. Sometimes, they don't even know that they are enrolled in the SNF. We also tried calling Medicare to verify that each patient was or was not in a SNF. This proved to be a waste of time because at the time of your call, their system may not have been updated, and the recoupment came anyway.
Here's what I do, and suggest for you:
1. Continue to ask Medicare patients if they are enrolled in a SNF under a part A stay. If so, send any charges, which are subject to consolidated billing, to the SNF on a HCFA 1500. Be sure you bill them at the Medicare rate, because that's all they'll pay.
2. Split every x-ray charge (or any other charge which would be subject to SNF colsolidated billing) into technical and professional components, whether you have SNF info on them or not. For example, x-ray of left shoulder, complete - instead of billing 73030-LT, bill 73030-26-LT and 73030-TC-LT. Medicare gladly processes them this way. When the recoupment comes later, they will only recoup the technical component. Then, all you need to do is obtain the SNF info for that patient and send the TC charge to them.
This doesn't eliminate the headache completely, but will greatly help.
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