The Medicare Billing Manual for Long-Term Care

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9781615691944: The Medicare Billing Manual for Long-Term Care
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Conquer no-pay bills, exhaust billing, and ensure proper reimbursement under RUG-IV

The Medicare Billing Manual for Long-Term Care provides easy-to-understand guidance to help long-term care facilities correctly file Medicare Part A and Part B claims. It breaks down the often misunderstood consolidated billing process, clarifies the appropriate use of beneficiary notices, and offers practical solutions for billing under RUG-IV.

The Medicare Billing Manual for Long-Term Care will help you:

- Understand and comply with the billing changes under RUG-IV
- Correctly file monthly, no-pay, and benefits exhaust claims
- Complete the UB-04 accurately
- Apply expert insight and insider tips to your SNF consolidated billing
- Understand which ancillary services are covered under Part B
- Increase cash flow and financial viability with Part B billing
- Avoid auditor scrutiny by correctly submitting claims to Medicare on the first try

Table of Contents

Chapter 1: Overview and History of the Medicare Program
Chapter 2: Part A SNF Billing
Chapter 3: Billing for Ancillary Revenue
Chapter 4: Part B Outpatient Therapy Services and Billing
Chapter 5: Billing for DMEPOS
Chapter 6: Billing for Diagnostic Tests, Lab Services, and Radiology
Chapter 7: Billing for Screening and Prevention
Chapter 8: Ensuring a Solid SNF Billing System
Appendix A: Acronyms
Appendix B: Forms


When you purchase this book, you will also receive on-line access to a number of valuable tools, which you can download straight to your desktop, then customize to fit your specific needs. Among the tools available include:

- RUG-IV classification chart (shows the breakdown of RUG-IV classification)
- RUG spider chart
- RUG grouper criteria chart
- ADL calculation chart
- UB-04 top sections that reveal code changes

"synopsis" may belong to another edition of this title.

About the Author:

Frosini Rubertino, RN, C-NE, CDONA/LTC, CPRA, is a regulatory specialist with more than 25 years of healthcare experience. She has trained and advised long-term care staff on how to achieve compliance and maintain excellence in their respective roles.

As the executive director of, Rubertino is a nationally recognized regulatory specialist and instructor for HCPro's Survey Prep Boot CampSM and Medicare Boot Camp® Long-Term Care Version. She is the author of HCPro's The QIS Mock Survey Guide, is a member of the editorial advisory board for HCPro's Billing Alert for Long-Term Care, and has contributed to numerous published articles related to PPS and Medicare billing.

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HCPro Inc., Frosini Rubertino RN C-NE CD
Published by HCPro Inc. (2013)
ISBN 10: 1615691944 ISBN 13: 9781615691944
New Paperback Quantity Available: 1
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