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Wiki Skilled Nursing Facility billing help

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bkhattak

Networker
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Location
Richmond, TX
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Hello! All,
I am having an issue in billing Humana for skilled services, I billed them according to PPS with HIPPS codes and ancillary charges but they denied my claim by giving the reason of incorrect billing and instructing me to put in revenue codes 190 and 191. I would really appreciate if somebody have any knowledge or know something about billing commercial payers for skilled services.


Thanks
Bilal
 
Yes that is pretty common as most commercial payers don't reimburse using SNF PPS they reimburse per diem on the Room and board rev codes. If you are contracted it will likely show this info in the contract along with what the per diem rate is
 
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