tci Medicare Compliance & Reimbursement - 2004 Issue 25

LONG-TERM CARE: SNFs, Suppliers Must Shake Hands On Consolidated Billing

Communication breakdowns lead to big billing problems for both. Suppliers' claims are coming up short on compliance for Part B services under a Part A skilled nursing facility stay. But according to the HHS Office of Inspector General, SNFs share the blame. A nationwide OIG audit of claims from 1999 and 2000 revealed that Medicare often paid twice for the same service -- once to a SNF under the Medicare Part A prospective payment system and again to an outside supplier under Medicare Part B. The result was $108.3 million in overpayments that the OIG says it will...

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