Skilled Nursing Facilities: Medicare Billing and Payment Fundamentals

If you sell to skilled nursing facilities (nursing homes), it’s essential to understand how they get paid for their services. In this course, we’ll focus on one specific, very important payment system: Medicare.

Medicare isn’t the most common payer in most nursing homes – typically, more patients rely on Medicaid. However, Medicare is usually the payer that contributes most to profitability, and therefore the one that is most critical to your customers.

Medicare coverage in the skilled nursing facility (SNF) is strictly limited. This course has been developed to clarify how and when Medicare pays for services and products provided in skilled nursing facilities.

For a basic understanding of nursing homes and other extended care providers, refer to the AMS Sales Training course Understanding Long Term Care Customers.

After completing this course, you will understand:

• Medicare payment structures for skilled nursing facility care
• Medicare Part A, Part B, and Part D coverage
• Medicare Advantage (Part C) plans
• Consolidated billing requirements
• Ethical issues and questionable marketing and sales practices
• Resources for obtaining reimbursement information