When treating a patient that lives in a skilled nursing facility (SNF), it is important to understand the coding and billing guidelines of consolidated billing. That is because certain services must be consolidated and submitted by the SNF using its Medicare provider number, and not submitted by you, the physician, unless they are one of the excluded services, which will be further discussed below.
Coding Corner Question
Skilled nursing facility patients
Coding Corner Answer
Skilled nursing facility patients
Practice Page: Protecting Your Practice through Compliance
Compliance programs are an effort by the government to maintain integrity in the healthcare system. These programs target activities causing improper payment to determine their root cause: Was it a mistake or error, was it inefficiency or waste of resources, is the provider bending the rules or abusing the system, or was it intentional deception or fraud? There are also laws dictating the compliance culture within practices and institutions; for example, red-flag rules, antikickback statute, and stark law, to name a few.
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