Medicare Fundamentals Part 8: Consolidated Billing and Essential Medicare Meetings On-Demand Workshop

Is the facility paying for services that they are not responsible for? Is it unclear why the facility is getting a bill for certain services from the physician? Under Medicare Part A, facilities are paid a daily rate calculated from the MDS. Out of this daily rate, the SNF is required to pay for all the goods and services provided to the beneficiary while they are a resident in the SNF under a Medicare Part A paid stay, a consolidated bill. There are some items that are excluded from this consolidated bill, meaning these are services that are typically outside the scope of services provided in a SNF and are not the responsibility of the SNF. Following Medicare Fundamentals Part 8: Consolidated Billing and Essential Medicare Meetings, you will be able to apply the basics of consolidated billing including how to determine if a service is not the responsibility of the facility. In addition, this session will provide examples of several beneficial facility meetings that could be conducted to ensure Medicare coverage guidelines are met including the daily PPS meeting, the weekly Medicare meeting, and the monthly triple check meeting.

Jennifer LaBay RN, RAC-MT, RAC-MTA, CRC

Curriculum Development Specialist

AAPACN

Jennifer LaBay, RN, RAC-MT, RAC-MTA, CRC, is a curriculum development specialist with AAPACN. She has been involved in the RAI process since 1997 and has been in the long-term care industry since 1991 serving in a variety of capacities including laundry aid, certified nursing assistant, charge nurse, nurse assessment coordinator, regional corporate clinical reimbursement specialist, and independent clinical reimbursement consultant. Jennifer has been a Master Teacher for AAPACN’s RAC-CT program since July 2011 and AAPACN's RAC-CTA advanced certification since 2019. She has been a Certified Risk Coder (CRC) through the American Academy of Professional Coders (AAPC) since 2020. Jennifer has considerable expertise in the MDS 3.0 and RAI process, the prospective payment system (PPS), and ICD-10 coding including the clinical and financial aspects. She has a knack for making her seminars an enjoyable learning experience and readily makes herself available to all attendees of her programs for any follow-up questions that may arise long after the seminar is complete.

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