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Do You Know Your Medical Billing RUG’s?

Do You Know Your Medical Billing RUG’s?

Published by: Melissa Clark, CCS-P on November 24, 2005

Do You Know Your Medical Billing RUG’s?

The New RUG III should bring added reimbursement to freestanding facility medical billing across the country. These new changes will boost payment between 2.4% and 2.9% if the facility handles medical billing correctly. If medical billing is handled incorrectly, a drop in payments could be seen for skilled nursing.

Training is of the utmost importance coming up on the new year. If a facility has rehab residents with cushioned care with add-on payments, the RUGs will throw them into a lower paying bracket. Understanding the Medicare per diem levels will be very important when it comes to reimbursement for services.

There are several tips to keep in mind when performing rehab medical billing. Be sure your personnel document the look-back period in the hospital. You should also be sure the therapy department and the nursing department are in close communication. Communication is key when dealing with medical billing.

Another important element to remember in medical billing is to document the DMS of each resident. You need to accurately show that the patient needs assistance will daily living activities. The new RUG states that the lower threshold limit for this in medical billing is an index of 7.

Your medical billing staff members are not the only employees that should be aware of the RUG changes. be sure your administration, nurses, physical therapists, and managers are aware of the changes as well.

In order for medical billing to be complete and accurate, all staff members must be held accountable. You cannot get correct medical billing if your nurses don’t communicate well. You also won’t get correct medical billing if administration doesn’t know the correct policies. Your medical billing team members, as well as the rest of your staff, are important to the success of your facility

Published by: on November 24, 2005

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