Course Code: REL-PAC-0-CONB
Hours: 1
Type: Online Course
Content Expiration Date: 12/31/2028
Learning Objectives:
Define who identifies as a "resident" for consolidated billing purposes.
Identify at least two items that are included and two items that are excluded from SNF consolidated billing.
Describe the major categories of items or services under consolidated billing.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Introduction to Consolidated Billing
Terminology
Defining Consolidated Billing
Definition of “Resident” for Purposes of Consolidated Billing
Review
Summary
Section 3: Consolidated Billing Major Category Exclusions
Major Categories
Major Category I: Exclusion of Services Beyond the Scope of an SNF
Major Category II: Additional Services Excluded When Rendered to Specific Beneficiaries
Major Category III: Additional Excluded Services Rendered by Certified Providers
Major Category IV: Preventative and Screening Services
Major Category V: Part B Services Included in SNF Consolidated Billing
Review
Summary
Section 4: Additional Excluded Services
Professional Services
Ambulance Services
Medicare Non-Covered Services
Review
Summary
Section 5: HCPC Files
Introduction to the HCPC Files
Section 6: Limiting Financial Liability
Limiting Financial Liability Under Consolidated Billing
Best Practice Guidelines for Reviewing Provider Invoices
“Under Arrangement”
Medicare and Physician Fee Schedules
Review
Course Summary
Course Contributor
Resources
References
Subject Matter Expert: Kimberly Matthews, RN
The content for this course was created or revised by Kimberly Matthews, RN obtained a nursing degree from Western Kentucky University in 1998. Ms. Matthews possesses over 20 years of nursing experience with over 17 of those in the Skilled Nursing industry. Ms. Matthews has extensive experience in MDS, restorative nursing programs, and nursing management. Ms. Matthews is currently a Post-Acute Care Content writer and subject matter expert for MDS.
Target Audience:
The target audience for this course is: Nursing Personnel; in the following settings: Skilled Nursing Facility.
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All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.