PPS RUG IV Information
RUG IV Category Qualifiers SNF PPS Proposed Rule 2012 **NEW** ***NEW*** FY2012 SNF PPS Final Rule RUG Tree with URBAN CMI Values for 10/1/2011 RUG Tree with RURAL CMI Values for 10/1/2011 Updated CMS Q & A Oct 2011 ***NEW*** CMS PPS Clarifications March 2012
Consolidated Billing
CB Invoice Review Flow Chart
CMS Consolidated Billing Website 2012 Excluded Chemo Drugs
Medicare Billing/Claims Management
Request for Redetermination Request for Reconsideration Request for ALJ Hearing
Beneficiary Notices/Expedited Review Process
Expedited Determination Final Rule Medlearn Matters Exp. Review Q & A 8/05 Exp. Review Q & A 3/06 SNFABN Q & A (11/06)
BNI Forms Usage Guide CMS Beneficiary Notices Memo (1/09) ***NEW*** CMS 10123 (NOMNC) 3/2012 ***NEW*** CMS 10124 (DENC) 3/2012
Other Topics Related to LTC Industry
OIG RUG Accuracy Report 3_06 OIG RUG Accuracy 3/06 Blood Glucose Billing in SNFs (11/06)
Articles by Clinical Reimbursement Solutions
Consolidated Billing (ECPN Mag.9/05) RUG Refinements (ECPN Mag 11/05) Medicare Claims Appeal Process (ECPN Mag 3/06) Therapy Caps Exception Process (ECPN 6/06) Benefits Exhaust/No Pay Claims (CLTC, 10/06) Blood Glucose Billing (ECPN 03-07)
Misc Links
CMS Internet Only Manuals CMS Transmittals