***NEW*** 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
Consolidated Billing
CB Invoice Review Flow Chart
CMS Consolidated Billing Website Excluded Chemotherapy Drugs (effective 1/1/2011)
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 Generic Notice (updated 8/08) Detailed Notice (updated 8/08) Final Rule 10/7/2005 Generic Form Instructions Expedited Determination Final Rule 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)
Other Topics Related to LTC Industry
OIG RUG Accuracy Report 3_06 Pneumococcal/ Influenza Final Rule 10/05 OIG RUG Accuracy 3/06 2007 OIG Workplan (SNF Info Only) Blood Glucose Billing in SNFs (11/06) 2008 OIG Workplan (SNF Info Only)
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