Skilled Nursing Facility 3-Day Rule Billing
Understanding the Skilled Nursing Facility (SNF) 3-Day Rule for Medicare Billing Navigating Medicare’s billing requirements can be complex, especially when it comes to the Skilled Nursing Facility (SNF) 3-Day Rule. This rule is critical for ensuring that Medicare covers SNF services, and understanding it can help prevent denied claims and unexpected costs for patients. Here’s […]
Medicare Part D Vaccines
Navigating Medicare Part D Vaccines: A Comprehensive Guide for Providers Medicare Part D provides essential coverage for a wide range of vaccines, crucial for preventing illnesses in the Medicare population. Understanding the distinctions between what Medicare Part D and Part B cover, as well as how to properly bill for vaccines under Part D, is […]
Understanding Medicare & Medicaid for Dually Eligible Beneficiaries
Dually eligible beneficiaries are individuals who qualify for both Medicare and Medicaid, making them eligible for a broad range of healthcare services. These beneficiaries typically have limited income and resources, qualifying them for additional support to cover healthcare costs that Medicare does not fully pay. Here’s a detailed guide to understanding the benefits, billing practices, […]
Replacement Wheelchair Equipment When Manufacturers Exit the Business
Hospice Payment Rates and Cap Updates
The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 13707, effective October 1, 2024, which introduces critical updates to hospice payment rates, the hospice wage index, and the hospice cap amount for the fiscal year (FY) 2025. These changes are essential for hospice providers to understand and implement as they impact […]
Refining Home Health Payment Reductions for Quality Data Submission
The Centers for Medicare & Medicaid Services (CMS) has issued an important update through Change Request (CR) 13241, which becomes effective on January 1, 2023. This update is designed to enhance the accuracy and efficiency of payment processes for Home Health Agencies (HHAs) that do not submit the required quality data. The update fully replaces […]
