Opportunities related to Medicare bad debt reimbursement
Key considerations for skilled nursing facilities
SENIOR LIVING HEALTH CARE CONNECTION |
Authored by RSM US LLP
Skilled nursing facilities (SNFs) are often missing out on additional Medicare reimbursement due to a lack of resources, time and accurate record keeping. Typically, providers are reimbursed 65% of their Medicare bad debts that are filed on the annual Medicare cost report. In order to identify and report these Medicare bad debts, there are steps SNFs should take, including:
- Summarize Medicare bad debts for deductibles and coinsurance, excluding deductibles and coinsurance for physicians’ professional services and net of bad debt recoveries. This can be done by comparing a detailed provider statistical and reimbursement report to your records.
- Proper collection must be followed and documented in the resident file.
a. Traditional Medicare bad debts must have attempted collection efforts for a minimum of 120 days, beginning on the date the first bill is sent to the resident. If the resident submits a payment, the 120-day period will restart. When a provider uses a collection agency, they cannot be written off as bad debt until returned from the collection agency as uncollectible.
b. Medicare/Medicaid crossover bad debts must bill Medicaid and wait for a remittance advice documenting payment, prior to writing off the bad debt.
- Medicare bad debts can be claimed on your annual Medicare cost report, based on the actual write-off date. The write off date must be within the cost reporting period for the Medicare cost report being filed.
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This article was written by Amanda Springborn, Brian Katz and originally appeared on 2021-04-13.
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