Understanding Consolidated Billing

Course overview

This course is designed to provide a better understanding of SNF PPS consolidated billing rules and regulations. A thorough understanding of how consolidated billing works is an important safeguard to the financial stability of the skilled nursing facility (SNF). This module covers terminology, definition of consolidated billing, the definition of “resident” for purposes of consolidated billing, major category I-IV exclusions, the HCPC file, professional versus technical component, principles to limit financial liability, best practice guidelines for reviewing provider invoices, and Medicare and physician fee schedules.