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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Medicare is the secondary payer: Now what?

July 6, 2018
Billing Alert for Long-Term Care

While Medicare is most often the primary payer for Medicare beneficiaries, some beneficiaries are also covered by an insurance plan that is primary to Medicare (i.e., must be billed before Medicare). This is different from the secondary insurances that many beneficiaries have, which will pay for additional costs not covered by Medicare. In cases when the insurance is the primary payer, the insurance must be billed before any claims can be submitted to Medicare.

New proposed payment system, Part 2: Changes to the RAI process

July 13, 2018
Billing Alert for Long-Term Care

The Centers for Medicare & Medicaid Services’ (CMS) new proposed payment system, the Patient-Driven Payment Model (PDPM), follows multiple recommendations from the Medicare Payment Advisory Commission to revise the current prospective payment system (PPS). The revisions include transitioning reimbursement from a volume-based to a value-based system, which accounts for individual patient characteristics, captures more clinical complexity, and reduces the focus on therapy minutes by correlating reimbursement with a broader spectrum of care services.

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