Wiki Billing SNf for Medicare Part B claims

[dmccullers]

We have been getting refund requests from Medicare due to bills should have been sent to the SNF instead of Medicare.

2 questions:
1. How are we to know which patients still have Part A benefits and claims should be sent to the SNF?
2. Do we send a claim form to the SNF or a statement? (we have been sending statements, but we are having a hard time getting the SNF to pay)

Thanks for your help.

 

[thurstonpark]

HI

That means the SNF either did not discharge the patient from the medicare cert bed or the patient is under Med A stay and your bill is considered consolidated billing.

 

[dmccullers]

That is correct.

My question is how will we know a patient falls under consolidated billing when the patient is in our office?
How do we bill the SNF? On a 1500 claim form or a statement?

 

[vjensenbfp]

You need a HCFA. Sometimes we would have to call the nursing home to see if they are in a skilled bed. I would have the phone girls flag the account if a nursing home schedules the appointment. And note which home. Also the front desk to let billing know if they came from a home. Some homes send paperwork.
I also had access to the hospital med records online and it would state where they discharged to. It was,always a pain to refund Medicare after the fact