Tuesday, March 20, 2018

CMS Posts Provider Compliance Tips for SNF Documentation

Dan Ciolek

The Centers for Medicare & Medicaid Services (CMS) recently posted a brief Medicare Learning Network Fact Sheet, “Provider Compliance Tips For Skilled Nursing Facility Services”. 

This document points out that the skilled nursing facility (SNF) Medicare Fee-For-Service (FFS) improper payment rate for fiscal year 2017 was 9.3 percent, accounting for 8.9 percent of the overall Medicare FFS improper payment rate. Additional details on the SNF payment error rate can be found here.   

Per CMS, “The majority of SNF service improper payments [85%] were from insufficient documentation. The primary reason for these errors was the certification/recertification statement was missing or insufficient (for example, one required element was missing).”  

The remainder of the fact sheet provides several tips and links to additional information to assist SNF providers in identifying documentation necessary to help prevent such denials.  AHCA recommends that providers share this information with referring physicians, and SNF clinicians and billers.   

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