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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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.

ICD-11 is here and U.S. is mulling its use for mortality reporting

Nov 30, 2018
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Billing Alert for Long-Term Care

As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption. That would be the International Classification of Diseases 11th Revision, otherwise known as ICD-11, which was released by the World Health Organization (WHO) in June after a decade in development. And U.S. officials are already considering a switch to the codes—for use on death certificates.

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

Achieve accurate reimbursement and compliance with these best practices

Nov 09, 2018
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Billing Alert for Long-Term Care

A best practice is a technique or methodology that, through experience and research, has proven to reliably lead to a desired result. In any industry, best practices are developed over time. Professionals involved in the revenue cycle of a long-term care (LTC) facility must have a solid understanding of the fundamentals of claims processing as they relate to the Medicare regulations and the facility’s state Medicaid reimbursement system.

Featured member resource: MDS chart audit tool

Nov 09, 2018
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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.

 

473 changes to ICD-10 codes

Oct 19, 2018
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Billing Alert for Long-Term Care

Coding tells the detailed story of your facility’s patient care, morbidity, and sometimes demographic information. ICD-10 coding in long-term care has several purposes, including to:

  • Collect diagnostic and statistical data
  • Support clinical decision-making
  • Verify medical necessity
  • Validate need for supportive procedures, treatments, and therapies
  • Support reimbursement for services provided
  • Determine RUG scores
  • Correctly code diseases on the MDS, UB-04, medical reports, therapy treatments, and ancillaries

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.

Key documentation criteria for supporting the Medicare claim

Sep 21, 2018
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Billing Alert for Long-Term Care

Medicare documentation must provide accurate information to support the necessity of skilled services provided to a resident. Nursing documentation is vital and must reflect the reason for admission to skilled services, the delivery of skilled services, and justification for skilled services to continue. All of these elements, combined with the documentation within the entire medical record, help to justify and support your Medicare claim.

Seven tips for reviewing and responding to PEPPER reports

Sep 14, 2018
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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. 

Resident-centered care in a data- and payment-driven industry

Jul 19, 2018
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Billing Alert for Long-Term Care

SNFs must provide quality care to residents in a field that is being suffocated by regulation and paperwork, and that is placing ever-increasing importance on data. The key is to ensure the data does not eclipse the care. SNFs must adhere to the principle that putting residents first will improve quality measures, increase reimbursement rates, and ensure a successful survey. Enhancing resident care will then give a facility the reputational excellence it needs to fill its beds. 

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