tci Medicare Compliance & Reimbursement - 2004 Issue 19

Long-Term Care: Many SNFs' Dual-Eligible Claims Not Up To Snuff

Here's what SNFs need to know to get things done right.Billing for patients with both Medicare and Medicaid coverage can be tricky for skilled nursing facilities. But a March 31 audit of the Texas Department of Human Services dropped a few hints on how SNFs can get the matter cleared up. In the report, titled "Review of Medicaid Long-Term Care Payments for Individuals with Both Medicare and Medicaid Coverage" (A-06-03-00040), the HHS Office of Inspector General sent the state knocking on the doors of nursing homes in order to recoup over $7,800 in overpayments that occurred...

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