• Billing Patients During Skilled Nursing Facility Stays


    Many practices have claims rejected when they bill services furnished to patients who have a short-term stay in a skilled nursing facility.

    Patient rehabilitation in such facilities will impact your billing even when you see the patient in your office. Payers do not cover services provided to patients while they receive care in a skilled nursing facility. Services not covered in such circumstances include the technical component (-TC) of any test, post-cataract glasses and injectable drugs.

    Follow these three steps to avoid rejected claims of this type:

    1. Confirm where patients are residing if it’s outside the home. The typical stay in a SNF is 20 days.
    2. Contact the facility before providing care and confirm that it will pay for these non-covered services due to place of service.
    3. Obtain all agreements in writing.

    Skilled nursing facilities are not required to reimburse the practice. Thus, you face a high possibility of lost revenue, especially with expensive drugs. If the patient must receive an injection during the stay, consider also reaching out to the drug company for samples.