A few helpful educational resources have been recently released and/or updated by the Medicare Learning Network pertaining to skilled nursing facility compliance and billing.
A revised Dual Eligible Beneficiaries under the Medicare and Medicaid Programs Fact Sheet is available. The fact sheet provides an overview of the Medicare and Medicaid Programs and dual eligible beneficiaries, the prohibited billing of qualified Medicare beneficiary individuals, Medicare assignment and more. A companion revised Special Edition MLN Matters Article on Prohibition on Balance Billing Dually Eligible Individuals Enrolled in the QMB Program is also available which covers important clarifications concerning Qualified Medicare Beneficiary (QMB) balance billing rules and ways to improve processes related to QMB individuals.
The Skilled Nursing Facility (SNF) Consolidated Billing Web-Based Training (WBT) course is also available through the Learning Management and Product Ordering System. Participants in this training course will learn about payment information for SNF services, including services provided by entities other than the SNF, as well as bundled prospective payments.
And finally, The Medicare-Required Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Assessments Educational Tool is available. Readers will learn about assessment overviews; factors affecting the assessment schedule and assessment results reporting. This is a handy reference tool for MDS coordinators.