Medicare Compliance & Reimbursement

Even if your provider doesn’t see many NF patients, be proactive and have a contract ready.

When your physician sees a nursing facility (NF) patient in the office, you will likely need to bill a portion of the encounter to the payer and another portion to the nursing facility, thanks to Medicare’s consolidated billing rules. Reduce payment delays and frustration by having a set contract such as this one in place.

Keep in mind: There are additional details you’ll want to add to this basic sample contract to make it specific for your practice’s needs, and you should have a competent healthcare attorney with Stark knowledge review the contract.

Date:

This letter serves to document an agreement between me, John Doe, MD, and XYZ Skilled Nursing Facility.

At your request, I may provide medically appropriate services to patients from your facility who are classified by the Medicare program as under skilled nursing facility care. Following evaluation and treatment, my office will send an invoice directly to your facility for reimbursement of the medical care services I have provided, at your request, to these patients.

Payment will be expected regardless of your facility’s reimbursement status with Medicare.

Payment should be mailed directly to the address below within 10 days following receipt of my invoice.

Provider tax ID number:

Please send payment to:

Billing Office Address

City, State, ZIP code

Signatures by both parties below acknowledge and consent to the above agreement.

Signature of Physician and Date ___________________

Signature of SNF and Date_____________________ .