Welcome to The Billers' Association For Long-Term Care

The Billers’ Association for Long-Term Care is a membership community created specifically for long-term care billing professionals. This national association provides members with a resource of continuously updated tools, billing-specific education, and reimbursement and regulatory guidance. Become a member today and join your long-term care billing colleagues as you navigate the evolving world of post-acute care billing.

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Featured Resource

Ambulance Services Included & Excluded Under SNF Consolidated Billing

Dec 05, 2018
 | 
The Bottom Line

If an ambulance is needed to facilitate the provision of a CB category III service, the trip should be accounted for in the SNF’s consolidated bill. Ambulance trips for category III services are not excluded from consolidated billing, regardless of whether or not they meet the medical necessity criteria. Download this quick reference tool, Ambulance Services Included & Excluded Under SNF Consolidated Billing, to identify which ambulance services are included and excluded from SNF consolidated billing.

News & Analysis

New member resource for your compliance & ethics program

Dec 07, 2018
 | 
The Bottom Line

As a result of updated survey protocols published in Appendix PP of the State Operations Manual on March 8, 2017, SNFs must have a compliance & ethics program in place by November 28, 2019. Implementing written policies and procedures is one element suggested by CMS to achieve a successful program, and having policies and procedures for the billing department is no exception. Download our Sample Policy for Reporting Overpayments to ensure that any known overpayment received by a federal healthcare program is appropriately refunded to avoid losing revenue dollars.

Case study: Consolidated billing, major category I

Dec 07, 2018
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The Bottom Line

Background: To illustrate the different billing requirements that apply to professional and technical components of a service, consider Malcolm, a beneficiary who visits the physician office in the midst of a Part A SNF stay to receive a chest x-ray. The physician performs the x-ray, then interprets the results. The administration of the x-ray constitutes the technical component, whereas the interpretation of the results represents the professional component of the total x-ray service.

KX modifier amounts announced for CY19

Dec 07, 2018
 | 
The Bottom Line

The annual per-beneficiary incurred expense amounts are now known as the KX modifier thresholds. These amounts were previously associated with the financial limitation amounts that were more commonly referred to as “therapy caps” before the application of the therapy limits/caps was repealed when the Bipartisan Budget Act of 2018 (BBA of 2018) was signed into law. CMS recently posted a MLN Matters article with these amounts for CY2019, which were lowered by the BBA of 2018 which are as follows.

Ambulance Services Included & Excluded Under SNF Consolidated Billing

Dec 05, 2018
 | 
The Bottom Line

If an ambulance is needed to facilitate the provision of a CB category III service, the trip should be accounted for in the SNF’s consolidated bill. Ambulance trips for category III services are not excluded from consolidated billing, regardless of whether or not they meet the medical necessity criteria. Download this quick reference tool, Ambulance Services Included & Excluded Under SNF Consolidated Billing, to identify which ambulance services are included and excluded from SNF consolidated billing.

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