What would the next step be for a claim that denied because the beneficiary was in a Skilled Nursing Facility (SNF)?
If the beneficiary is enrolled in a covered Part A Stay, the SNF and not the supplier would bill Part A. As a result, you would look to the SNF for payment rather than the beneficiary or the DME MAC. For more information regarding Skilled Nursing Facilities, including a link to the Consolidated Billing List, as well as a list of the items which are billable when the beneficiary is in a non-covered Part A stay, please see the DME MAC Jurisdiction C Supplier Manual, Chapter 6. Also, SNF/inpatient hospital stay information is available on the DME MAC Jurisdiction C IVR. The SNF/inpatient hospital stay option provides: • Whether or not a beneficiary has a SNF or inpatient hospital facility claim on file for the date of service entered • NPI of the facility if the beneficiary is still a patient • Type of discharge • Discharge date To access the SNF/inpatient hospital stay option on the IVR, press option 2 (Beneficiary Information) from the main menu, then press 4 (SNF/Inpatient Hospital sta
Related Questions
- When Hyperbaric Oxygen Therapy (HBO) is administered in a skilled nursing facility (SNF), how is the provider reimbursed for the HBO therapy?
- How must the Skilled Nursing Facility (SNF) notify a beneficiary that the beneficiary no longer needs a Medicare skilled level of care?
- When must the Skilled Nursing Facility (SNF) notify a beneficiary that he/she no longer needs a Medicare skilled level of care?
