Welcome to The Billers' Association For Long-Term Care

The Billers’ Association for Long-Term Care (BALTC) is a membership community created specifically for professionals involved in the long-term care revenue cycle. This national association provides members with a resource of continuously updated tools, reimbursement and regulatory guidance, and education to help prevent revenue loss and documentation and billing errors so providers can withstand audits at any point in time. With its involved expert advisory board members and active talk group, this engaged group of professionals is a great place for sharing and receiving best practices, tips, and tools with your peers.

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Featured Article

A tool for your CNAs to help with accurate ADL documentation

June 22, 2018
 | 
The Bottom Line

The SNF PPS establishes a schedule of Medicare assessments, and each assessment supports reimbursement. These scheduled assessments establish per diem payment rates for associated standard payment periods. A very important element that feeds PPS reimbursement is the measurement of the level of independence each resident has in activities of daily living (ADLs) for the late-loss ADLs: bed mobility, transfer, toilet use, and eating. Each is a cost center category, and it becomes highly important that certified nursing assistants/geriatric nursing assistants, who typically perform these observations and tasks, understand the need to accurately document the level of assistance provided to the resident.

News & Analysis

New Medicare cards: What’s that square code?

June 22, 2018
 | 
The Bottom Line

CMS published an announcement explaining that some of the new Medicare cards may have a square code, also referred to as a QR code (a type of machine-readable code).

“The QR codes on Medicare cards allow the contractor who prints the cards to ensure the right card goes to the right person with Medicare or Railroad Retirement Board (RRB) benefits. Providers cannot use it for any other purpose. The RRB issued cards may have a QR code on the front of the card while all other Medicare patients may get a new card with a QR code on the back of the cards. These are legitimate (official) Medicare cards,” says the announcement.

CMS issues guidance for handling insufficient documentation, ADRs

June 22, 2018
 | 
The Bottom Line

CMS issued change request (CR) 10778 on June 15, with an effective date of July 17, to update Chapter 12 of the Medicare Program Integrity Manual. The proposed update includes details for handling non-responders and insufficient responses to additional documentation requests (ADR) under the Comprehensive Error Rate Testing (CERT) program.

Full speed ahead: Assess and improve your work culture to achieve revenue integrity

June 22, 2018
 | 
Billing Alert for Long-Term Care

Editor’s note: Why isn’t revenue cycle management (RCM) practiced more often in long-term care? It not only requires an investment in an environment with many competing priorities, limited resources, and staff who are tasked with wearing multiple hats, but also involves getting buy-in from staff and senior leadership, which can be a struggle. With the proposed prospective payment system reform--which shifts the focus from time spent on providing services to a whole-resident approach--and CMS’ increased efforts to take back overpayments made by Medicare, it’s become increasingly evident that revenue integrity impacts all departments, not just billers.

A tool for your CNAs to help with accurate ADL documentation

June 22, 2018
 | 
The Bottom Line

The SNF PPS establishes a schedule of Medicare assessments, and each assessment supports reimbursement. These scheduled assessments establish per diem payment rates for associated standard payment periods. A very important element that feeds PPS reimbursement is the measurement of the level of independence each resident has in activities of daily living (ADLs) for the late-loss ADLs: bed mobility, transfer, toilet use, and eating. Each is a cost center category, and it becomes highly important that certified nursing assistants/geriatric nursing assistants, who typically perform these observations and tasks, understand the need to accurately document the level of assistance provided to the resident.

What should your policy for coding compliance and ethics include?

June 15, 2018
 | 
The Bottom Line

Coding continues to be a prime target for audits because errors, gaps, and missing information are easily identified. Also, the bundling and unbundling of codes impacts every area of healthcare. Additionally, coding is identified in audits and investigations and may be a source for whistleblower allegations under the False Claims Act.

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