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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Q&A from Biller’s Talk

Nov 20, 2018
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The Bottom Line

Q: This is my first time billing for the flu shots, can we add them to our Part A and Part B claims, or does it have to be a separate batch? Can you bill a roster through DDE?

A: Flu vaccines can only be reimbursed by Medicare Part B. They can be submitted via a roster or individual part b claims. You can bill a roster through DDE.

Featured questions from Biller’s Talk

Nov 16, 2018
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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?

New white paper available

Oct 26, 2018
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The Bottom Line

Download The Billers’ Association fourth quarter white paper: An in-depth look at how reimbursement is calculated under PDPM. Stefanie Corbett, DHA, post-acute regulatory specialist for HCPro breaks down tables and guidance from the final rule and PDPM calculation worksheet and provides a step-by-step guide to understanding the new payment model. Peruse this and previous year’s white papers on The Billers’ Association resources page. Have an idea for a topic you’d like to see? Write me at bshipley@hcpro.com.

CMS releases 2019 Medicare Parts A&B premiums and deductibles

Oct 19, 2018
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The Bottom Line

On October 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs. Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.  

CMS invites Medicare Part A providers to learn new Medicare Cost Report e-filing system

Oct 05, 2018
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The Bottom Line

Register for Medicare Learning Network events. Medicare Part A providers: Learn how to use the new Medicare Cost Report e-Filing (MCReF) system. Use MCReF to submit cost reports with fiscal years ending on or after December 31, 2017. You have the option to electronically transmit your cost report through MCReF or mail or hand deliver it to your Medicare Administrative Contractor. You must use MCReF if you choose electronic submission of your cost report. For more information, see the MCReF MLN Matters Article and MCReF webpage.

Updates to MDS 3.0 FY2019

Sep 28, 2018
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The Bottom Line

Changes to the Minimum Data Set (MDS) for skilled nursing facilities (SNFs) for the fiscal year 2019 include mechanical fixes (i.e. grammar, punctuation, capitalization, and text updates), clarifications and new items. Want a hard copy of this best-selling MDS 3.0 RAI User’s Manual? Check out HCPro’s version published with the latest updates on September 19, 2018. Facilities should prepare for the updates to the following sections effective October 1, 2018.

Q&A: Getting to know PDPM

Sep 28, 2018
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Billing Alert for Long-Term Care

Q: When will the reimbursement rates begin decreasing?

A: After the 20th day of a resident’s stay, the PT/OT rate components will decrease by 2% every 7 days. The NTA rate component will be reduced after the third day of a resident’s stay by two-thirds of the initial NTA rate component amount.

New Medicare card update

Sep 21, 2018
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The Bottom Line

CMS has confirmed that they are processing claims and eligibility requests with the Medicare Beneficiary Identifier (MBI), showing that providers are successfully using the new number. This week the agency began mailing new Medicare cards to people who live in Wave 6 states, which include Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Texas, Utah, Washington, and Wyoming.

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