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.

Learn More Join

Featured Article

CMS releases updates to billing for flu vaccine

 | 
The Bottom Line

Flu season is August to April. Make sure you’re prepared to start billing for the influenza virus vaccine by staying up to date on the latest code and payment allowance updates. So far, CMS has released the following two notices: 1. Payment allowances for the influenza virus vaccine are updated on August 1 each year. This year’s annual update has been released, according to a CMS MLN Matters article. Click here for 2018-2019 payment allowances and effective dates.

News & Analysis

CMS releases updates to billing for flu vaccine

 | 
The Bottom Line

Flu season is August to April. Make sure you’re prepared to start billing for the influenza virus vaccine by staying up to date on the latest code and payment allowance updates. So far, CMS has released the following two notices: 1. Payment allowances for the influenza virus vaccine are updated on August 1 each year. This year’s annual update has been released, according to a CMS MLN Matters article. Click here for 2018-2019 payment allowances and effective dates.

Self-disclosure can alleviate—not eliminate—penalties for fraudulent claims

 | 
Billing Alert for Long-Term Care

The interplay of Medicare billing and fraud seems like a perennial hot spot among SNFs. When an internal audit reveals potentially fraudulent discrepancies between care rendered and services billed on Medicare claims, determining the next steps can be tricky. Correcting faulty practices that led to the lapse is a given, but are broader legal actions necessary?

Seven tips for reviewing and responding to PEPPER reports

 | 
The Bottom Line

Every April, CMS makes the Program for Evaluating Payment Patterns Electronic Report (PEPPER) available for SNFs. The agency offers variant reports for a number of other Part A provider types, including hospitals, home health agencies, and hospices. These tools, which provide comparative billing data across a handful of setting-specific risk areas, can play an important part in a provider’s corporate compliance and ethics program. To get the most out of the report, SNFs should have a strategy in place for integrating its findings into their corporate compliance and ethics program before accessing this year’s edition. 

SNF final rule: Prepare for PDPM

 | 
The Bottom Line

CMS’ final rule, effective in October 2019, is a major overhaul for the long-term care industry, including SNFs. To survive, stakeholders must understand how reimbursement will work and how their facilities will need to function. Join expert speaker Stefanie Corbett, DHA, on Wednesday, October 24, 1:00-2:00pm, ET, for this 60-minute webinar. Learn what you need to know about the new case-mix groupings, how therapy is affected, and what SNFs need to do to remain viable in this new landscape.

Calculating reimbursement under PDPM

 | 
Billing Alert for Long-Term Care

Many staff members in a skilled nursing facility (SNF) have contributed to the minimum data set (MDS) under the current SNF prospective payment system, but few are able to explain how that documentation converts to a dollar amount or understand how the Centers for Medicare & Medicaid Services (CMS) defines a RUG rate. To help providers prepare for the transition from RUG-IV to CMS’ new Patient Driven Payment Model (PDPM), a calculation worksheet has been made available so staff will be able to explain how care services translate into reimbursement rates by the new payment model’s implementation date, October 1, 2019.

Resources

Community

Biller's Talk

Click here to join the discussion with fellow billing professionals and business office managers.

Free Resources

Access sample white papers, tools, analysis, and resources.

Subscribe to our free e-Newsletter

The Bottom Line is a free weekly e-newsletter that delivers news, tips, and strategies for long-term care billing professionals and business office managers on operating an efficient and compliant billing office.

Click Here to Subscribe Now!

Membership Information

Become a Member

Join the community created specifically for long-term care billing professionals.

Advisory Board

Advisors provide expertise and an industry voice for members.

Code of Ethics

A guide to the professional behavior of our members.

Sponsorship

The Billers' Association offers a variety of sponsorship opportunities.

Contact Us

For more information on joining the Association or questions about your membership.