SNF ABN and Medicare University Resources

TO:	RHCF Members
FROM:	Patrick Cucinelli, Senior Financial Policy Analyst
DATE:	June 11, 2009
SUBJECT:	SNF ABN  and Medicare University Resources
ROUTE TO:	Administrator, CFO, Billing Director, Therapy Director, Nursing Director

ABSTRACT: NGS offers guidance on advance beneficiary notices and biller certification.

Introduction
The process of issuing skilled nursing facility (SNF) advance beneficiary notices (ABN) remains one that generates some questions and confusion among providers.  Adding to the dilemma for providers is the fact that CMS has delayed the release of an all-inclusive SNF ABN comparable to the one now in place for home care which consolidates the Part A and Part B notifications.  Official guidance can be found on the CMS Web site which offers detailed information, announcements, and sample forms for the SNF ABN at: www.cms.hhs.gov/BNI/.

NGS Resource
At a recent meeting with our Medicare administrative contractor, National Government Services (NGS), NYAHSA raised the issue that the SNF ABN process is still a cause of concern for our members.  In response, NGS is providing the attached guidance in the form of a PowerPoint™ presentation recently released under the auspices of their Medicare University (MU).   The presentation entitled: Skilled Nursing Facility (SNF) Beneficiary Notices: What SNFs Need to Know is available by clicking on the link at the lower left of your screen.  This is a comprehensive and highly readable resource that members may download and keep for ready reference.  The appendix directly attached to this memo is an answer key to the review questions found in the presentation.

Medicare University
Also in response to NYAHSA’s request, NGS is planning to reprise their SNF ABN training session through their MU.  Please look for future announcements on this training by clicking on the MU link above or going to: http://www.ngsmedicare.com/ngsmedicare/partA/EducationandSupport/MedicareUniversity/MedUniv.aspx.

NGS has asked NYAHSA to remind members of the availability of the MU resource.  Through this feature NGS offers a wide range of free Medicare educational topics on a regular basis.  Much of the information is geared towards nuts and bolts issues of concern to billing and clinical staff.  NGS has designed the MU so that individuals can participate through teleconferences and Webinars without having to incur travel expense and time away from the office.

NGS issues certificates for completed sessions and tracks MU credits earned.  With enough credits earned NGS is offering their own certification in Medicare billing.  NGS also reports that some participants have been able to transfer their MU credits to other adult learning settings, even receiving college credit in some cases.  NGS is looking into the possibility of having MU become an accredited distance learning provider and thereby offering their own college credits.

Especially for nursing home billing staff, MU represents an excellent resource for advancing both knowledge and professional credentials.  NYAHSA recommends that providers who have not already done so should review the free MU resources.

Please contact me with any questions at pcucinelli@nyahsa.org or call 518-449-2707 ext. 145.

Attachments (2)

N:\NYAHSA\Policy\pcucinelli\ABN\June2009NGSpowerpointMU.doc

Appendix

Correct Answers:

Question 1.  TRUE – these are triggering events that will require a SNF ABN.

Question 2.  FALSE

Question 3.  YES – this is a triggering event which would cause an ABN to be issued.

Question 4.  NO – a SNF ABN does not have to be issued when it is not a Medicare benefit.

Question 5. #2 Informs beneficiary that Medicare is expected to deny.

Question 6.  FALSE – this is one of the requirements to be a legal guardian.

Question 7.  TRUE – this is one of the triggering events.

Question 8.  TRUE

Question 9.  TRUE

Question 10.  TRUE