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

Featured member resource: ADR appeal documentation checklist

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The Bottom Line

Upon receiving a request for additional documentation or when filing an appeal, a copy of the ADR appeal checklist should be printed. All applicable records on this checklist and supporting documents for the dates of service under review should be copied or gathered for electronic submission in addition to a clinical summary narrative cover letter that indicates skilled criteria and medical necessity. Download this members-only resource.

News & Analysis

Featured questions from Biller’s Talk

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The Bottom Line

Q: A patient came in from the hospital. The patient was admitted to Medicare Part A and was expected to stay, however after two hours, she wanted to go home and the physician ordered home health services. The patient didn’t sign the contract at the time of admission and didn’t sign an advance beneficiary notice (ABN). Does this count as a utilization day and should Medicare be billed using the AAA default rate?

Featured member resource: ADR appeal documentation checklist

 | 
The Bottom Line

Upon receiving a request for additional documentation or when filing an appeal, a copy of the ADR appeal checklist should be printed. All applicable records on this checklist and supporting documents for the dates of service under review should be copied or gathered for electronic submission in addition to a clinical summary narrative cover letter that indicates skilled criteria and medical necessity. Download this members-only resource.

Privacy concerns for the business office

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The Bottom Line

The following is an excerpt from an article that originally appeared in the October 2018 issue of Briefings on HIPAA.

HIPAA permits the use and disclosure of PHI for treatment, payment, and healthcare operations (TPO). In other words, covered entities (CE) like medical providers can share PHI with other CEs and business associates in the course of conducting normal operations—to treat patients, receive payment for services, or conduct audits, quality checks, and performance management to improve healthcare operations.

Featured member resource: MDS chart audit tool

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The Bottom Line

The purpose of the MDS chart audit tool is to ensure documentation is present in the medical record to support the findings of the MDS. Use the tool at the end of the month or the episode of care. If documentation that supports the MDS is present for each item, place a checkmark. If it is not, highlight the area so it can be followed up on to ensure completeness. This form can be completed by the MDS coordinator, DON, medical records, therapy director, or delegated per area of specialty. Download this Billers’ Association for LTC member resource.

 

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Advisors provide expertise and an industry voice for members.

Code of Ethics

A guide to the professional behavior of our members.

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