The Medicare Billing Manual for Long-Term Care (Paperback)

The Medicare Billing Manual for Long-Term Care By Frosini Rubertino Cover Image

The Medicare Billing Manual for Long-Term Care (Paperback)


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The Medicare Billing Manual for Long-Term Care

Conquer no-pay bills, exhaust billing, and ensure proper reimbursement under RUG-IV

The Medicare Billing Manual for Long-Term Care provides easy-to-understand guidance to help long-term care facilities correctly file Medicare Part A and Part B claims. It breaks down the often misunderstood consolidated billing process, clarifies the appropriate use of beneficiary notices, and offers practical solutions for billing under RUG-IV.

The Medicare Billing Manual for Long-Term Care will help you:

  • Understand and comply with the billing changes under RUG-IV
  • Correctly file monthly, no-pay, and benefits exhaust claims
  • Complete the UB-04 accurately
  • Apply expert insight and insider tips to your SNF consolidated billing
  • Understand which ancillary services are covered under Part B
  • Increase cash flow and financial viability with Part B billing
  • Avoid auditor scrutiny by correctly submitting claims to Medicare on the first try
Table of Contents

Chapter 1: Overview and History of the Medicare Program

Chapter 2: Part A SNF Billing

Chapter 3: Billing for Ancillary Revenue

Chapter 4: Part B Outpatient Therapy Services and Billing

Chapter 5: Billing for DMEPOS

Chapter 6: Billing for Diagnostic Tests, Lab Services, and Radiology

Chapter 7: Billing for Screening and Prevention

Chapter 8: Ensuring a Solid SNF Billing System

Appendix A: Acronyms

Appendix B: Forms


When you purchase this book, you will also receive on-line access to a number of valuable tools, which you can download straight to your desktop, then customize to fit your specific needs. Among the tools available include:

  • RUG-IV classification chart (shows the breakdown of RUG-IV classification)
  • RUG spider chart
  • RUG grouper criteria chart
  • ADL calculation chart
  • UB-04 top sections that reveal code changes
Frosini Rubertino, RN, C-NE, CDONA/LTC, CPRA, is a regulatory specialist with more than 25 years of healthcare experience. She has trained and advised long-term care staff on how to achieve compliance and maintain excellence in their respective roles.As the executive director of, Rubertino is a nationally recognized regulatory specialist and instructor for HCPro's Survey Prep Boot Campsm and Medicare Boot Camp(R)--Long-Term Care Version. She is the author of HCPro's The QIS Mock Survey Guide, is a member of the editorial advisory board for HCPro's Billing Alert for Long-Term Care, and has contributed to numerous published articles related to PPS and Medicare billing.
Product Details ISBN: 9781615691944
ISBN-10: 1615691944
Publisher: Hcpro Inc.
Publication Date: March 19th, 2013
Pages: 198
Language: English