Skilled nursing facilities play a critical role in providing specialized care to patients who require on-going medical attention. However, billing for these services can be complex, and many healthcare providers struggle to understand the guidelines and coverage offered by Medicare. In this blog, we will explore the Medicare coverage of skilled nursing facility billing and provide you with the guidelines you need to know. At 24/7 Medical Billing Services, we specialize in SNF billing and can help you navigate the process with ease.
Medicare Coverage of Skilled Nursing Facility Billing:
Under Medicare, skilled nursing facility services are covered for eligible patients who meet specific criteria. To qualify for coverage, the patient must have been admitted to a hospital for at least three days and must require skilled nursing care on a daily basis. In addition, the patient must require the services of a licensed nurse or therapist, and the care must be provided by a Medicare-certified skilled nursing facility.
Medicare coverage for skilled nursing facility services is divided into three phases:
- Days 1-20: Medicare covers 100% of the cost of care during the first 20 days of a patient’s stay in a skilled nursing facility.
- Days 21-100: From day 21 to day 100, patients are responsible for a daily co-payment, which is currently set at $185.50 per day. Medicare will cover the remaining costs.
- Days 101 and beyond: After 100 days, Medicare no longer covers the cost of care in a skilled nursing facility.
Skilled Nursing Facility Billing Guidelines:
Billing for skilled nursing facility services can be complex, and it’s important to follow the guidelines to ensure that you receive the appropriate reimbursement.
Here are some key guidelines to keep in mind:
Bill for services that are actually provided to the patient:
Ensure that your billing codes accurately reflect the services provided and are supported by proper documentation.
Follow the correct billing sequence, as errors in billing sequence can result in denials or delays in payment.
Monitor your claims regularly to identify any errors or issues and address them promptly.
How 24/7 Medical Billing Services Can Help:
At 24/7 Medical Billing Services, we understand the complexities of skilled nursing facility billing and can help you navigate the process with ease. Our team of experienced billers and coders can help you with all aspects of SNF billing, from verifying patient eligibility to submitting claims and following up on denials. We use the latest technology and billing software to ensure accurate and timely billing, and we stay up-to-date with the latest billing guidelines and regulations. With our help, you can reduce your billing errors, streamline your billing process, and increase your reimbursement.
Understanding the Medicare coverage of skilled nursing facility billing is crucial for healthcare providers who offer these services. By following the guidelines and working with an experienced billing partner like 24/7 Medical Billing Services, you can ensure that you receive the appropriate reimbursement for your services. Contact us today to learn how we can help you navigate the complex world of skilled nursing facility billing.
Contact us today to learn more about our SNF billing services and how we can help you streamline your billing process. With our help, you can reduce your billing errors, increase your reimbursement, and focus on providing quality care to your patients.