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Outline

1	Skilled Nursing Facility (SNF) Billing 101 Computer Based Training
2	What’s in it for me?
3	How important is communication between departments?
4	What are the billing rules? Send Part A claims to Medicare FI Monthly In sequential order Submit Part B claims For inpatient residents receiving therapies Other billable services
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6	UB-04
7	UB-04
8	UB-04
9	UB-04
10	UB-04
11	Revenue Codes FL 42 Required: 0022 for each HIPPS code 012X for room and board 0001 for the total charges
12	UB-04
13	UB-04
14	UB-04
15	UB-04
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21	Leave of Absence Beneficiary not present at midnight Returns within 24 hours May have more than one LOA Each LOA billed separately
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24	What about Part B claims?
25	What Type of Bill? Use a 0221 There is no Part A benefit Benefits exhaust but still skilled Use a 0231 Not a resident of the facility In a non-certified bed
26	SNF Part B
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33	Need more information? UB-04 Manual www.cms.hhs.gov 100-4, Chapter 25 www.medicare.gov Medicare & You 2007 www.wpsmedicare.com
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35	Thank you, you have competed the CBT. Would you like to take a 10 question knowledge check?
36	Without complete information from supporting departments, the billing staff can not complete accurate claims.
37	That is not correct, please try again.
38	True, all supporting departments should be involved to make sure that all claims are complete and accurate.
39	Use of the UB-04 is suggested by CMS, but any claim form is acceptable.
40	False, the UB-04 is the standard form that CMS established to be used by all Fiscal Intermediaries.
41	The items in the Patient Control Number field will appear on the Remittance Advice.
42	True, any information given in the Patient Control Number field will appear on the Remittance Advice.
43	Information regarding the available patient status codes can be found in the UB-04 manual.
44	True, a listing of patient status codes can be found in the UB-04 manual.
45	The patient’s nickname, rather than the name on the Medicare card, is entered in Form Locator 8.
46	False, the patients name, as it appears on the Medicare card should be entered into Form Locator 8.
47	Since payment for SNF Part A is based on PPS, there is no need to code any ancillary charges on the claim.
48	False, ancillary services received by the resident should also be included. This helps CMS determine the cost of care required for each RUG level when they do the annual rate reviews.
49	Three revenue codes that must be on every Part A SNF bill are 0022, 012X and 0001.
50	True, Part A (21X) bills must have revenue code 0022, 012X and 0001.
51	22X and 23X type of bills are synonymous and can be interchanged whatever the patient’s circumstance.
52	False, type of bill 22X should only be used when the patient does not have Part A or Part A has exhausted, but still remains at a skilled level of care, or in a skilled bed. Type of bill 23X is used for patients that have been moved to a non-certified bed or for patients who are non residents and come to the facility to receive Part B services.
53	The HIPPS codes determine the payment for the SNF Part A stay.
54	True, the HIPPS code determines the payment for the SNF Part A stay.
55	Medicare should be on the second payer line (FL 50) when they are the primary payer.
56	False, Medicare should be on the first payer line.
57	Thank you, you have competed the Knowledge Check. Would you like to take another CBT?