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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Billers’ Association 2019 quarterly webcast dates available, register now!

Dec 14, 2018
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The Bottom Line

As part of your Billers’ Association for Long-Term Care (BALTC) membership, you have access to a webcast each quarter hosted by BALTC Director of Content Brianna Shipley with panelist Stefanie Corbett, DHA, post-acute regulatory specialist for HCPro, and a select BALTC advisory board member. Panelists will discuss a variety of relevant and timely topics, including industry trends, updates, and best practices. Our members will receive guidance from, share opinions with, and have their questions answered by Medicare billing and reimbursement experts!

Tools to conduct an admission audit on your facility

Dec 14, 2018
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The Bottom Line

An admission audit generally occurs five days after an admission (not too early/not too late). The goal is to capture the completion of assessments, care plans, accuracy in medication reconciliation, and orders from the hospital. Depending on the findings, an opportunity for correction via late-entry documentation can occur. Download these admission audit and admission care plan/care card audit checklists to perform an audit on your facility to ensure you’re prepared for the real thing.

New member resource for your compliance & ethics program

Dec 07, 2018
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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.

Featured member resource: HIPAA authorization form

Nov 20, 2018
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The Bottom Line

Securing resident health information should be an ongoing effort that is constantly evaluated for effectiveness. There are several widely accepted measures that facilities should implement to protect resident health information and prevent data breaches. Safeguarding residents’ health information has always been a major concern in all healthcare settings, but it has taken on added importance with the implementation of EHRs and evolving HIPAA privacy and security rules

Verma says drop in improper payment rate is result of “focused effort to target root causes”

Nov 20, 2018
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The Bottom Line

CMS reports that the 2018 Medicare fee-for-service improper payment rate is at its lowest since 2010. The improper payment rate is in its second year of being below the 10 percent threshold for compliance established in the Improper Payments Elimination and Recovery Act of 2010. Corrective actions made by skilled nursing facilities in particular resulted in a $1.04 billion decrease in estimated improper payments from 2017 to 2018.

Op ed: Are postacute, site-neutral payments the future?

Nov 20, 2018
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Billing Alert for Long-Term Care

Editor’s note: The following is reprinted with permission from a post on Reg’s Blog dated October 2, 2018, the senior and postacute healthcare news blog written by Reginald M. Hislop III.

In the 2019 OPPS (outpatient PPS) proposed rule, CMS included a site-neutral payment provision. With the comment period closed and the lobbying against such a provision fierce, it will be interesting to see where CMS lands in terms of the final OPPS rule: Will they maintain, change, or abate? The one thing that is for certain, regardless of the fate of this provision, is that site-neutral proposals/provisions are advancing.

Privacy concerns for the business office

Nov 16, 2018
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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: ADR appeal documentation checklist

Nov 16, 2018
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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.

Healthcare winners and losers from election night 2018

Nov 09, 2018
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The Bottom Line

Source: HealthLeaders

The 2018 midterm elections are over but made a significant impact on healthcare policies at the federal and state level across the country, while also determining who will be in office to enact them. The future of healthcare policymaking will be influenced by the decisions made by millions of voters on Tuesday night, as Democrats took back the House while Republicans held onto control in the Senate. Healthcare was a top priority for voters as they made their way to the polls to vote on issues such as Medicaid expansion and the healthcare leaders seeking to represent them on Capitol Hill.

These 7 readmission risks could prevent you from receiving SNF VBP incentive payments

Nov 02, 2018
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The Bottom Line

As of October 1, 2018, the Skilled Nursing Facility (SNF) Value-Based Purchasing Program (VBP) rewards SNFs with incentive payments for reducing hospital readmissions. To receive incentive payments for this quality measure, make sure these 7 readmission risks don’t exist in your facility.

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