
Since the enactment of the Balanced Budget Act of 1997 (BBA), Skilled Nursing Facilities (SNFs) have been required to pay for and bill on their Part A claim all the services received by a SNF resident in Part A stay. This module will provide you with an understanding of how Consolidated Billing under the PDPM works. Billing and administrative staff will learn which residents are subject to Consolidated Billing, how to properly pay invoices, and determine the amount allowed for services provided by outside vendors.
In this training module, we will:
- Define the SNF Consolidated Billing.
- Distinguish between the facilities subject to SNF Consolidated Billing.
- Discuss the requirements for SNF Consolidated Billing.
- Identify SNF Consolidated Billing changes under the PDPM.
- Review the Medicare allowable amount per the Physician Fee Schedule and how to appropriately pay vendor invoices.