December 01, 2015
Senior Manager Janet Potter's article, "Ancillaries: They aren't just 'extras' on the UB-04," appeared in the December issue of HCPro's Billing Alert for Long-Term Care.
Is gathering all the information about ancillary services for Part A residents really necessary? Or is it just busy work?
Ancillary charges, including those from outside vendors, need to be included on the skilled nursing facility (SNF) Part A UB-04 for a number of reasons. In this article, we'll review the requirements to do so, then we'll explore ways to make the process smoother.
First, the Centers for Medicare & Medicaid Services (CMS) requires that SNF Medicare Part A claims include all the costs for a resident's stay. Under consolidated billing for SNFs, the Medicare PPS per diem is expected to cover the costs of all the care for the resident, with only a few specific excluded items. And the current Conditions of Participation for SNFs expect that all services provided to the SNF resident are the responsibility of the SNF.
This article appears in the December 2015 issue of Billing Alert for Long-Term Care, a monthly newsletter for Platinum members of HCPro's Billers' Association
for Long-Term Care.
For more information or to become a member, visit www.hcmarketplace.com/billers-association-for-long-term-care.