Urology Coding Alert

Clip and Save:

Tackle Payment Troubles With This Sample SNF Contract

Tip: Provide a copy to the SNF and keep one for your records



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 whom the Medicare program classifies 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. Our letter also notes that payment at the Part B Medicare-allowed amount is expected. 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_________________________ Editor's note: Consider having an attorney review any agreement or contract you plan to use before you obtain the signatures, to ensure the contract is in fact legal and binding.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Urology Coding Alert

View All