Welcome to your comprehensive resource page for Long Term Care Coding and direct billing. As a long term care provider, accurate coding is crucial for efficient billing and timely payments. This page is specifically designed to assist you with navigating the complexities of Healthcare and Family Services (HFS) billing processes, ensuring you have the information needed for successful claims processing. We address frequently asked questions and provide essential resources to streamline your billing procedures.
It is important to remember that healthcare policies and programs are subject to change. While we strive to keep this information as current as possible, always verify the latest guidelines and updates. We will post updated information as soon as it becomes available.
For immediate assistance or if you have specific billing inquiries, please do not hesitate to contact our billing consultants at 217-782-0545.
Essential Billing and Coding Information for Long Term Care Facilities
Navigating the nuances of long term care billing requires a solid understanding of coding practices. Correct coding ensures accurate claim submissions and reimbursements. Below are vital resources tailored to different types of long term care facilities, providing claim examples that incorporate essential coding principles:
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Skilled Nursing Facilities (PT 33) Claim Coding Examples (PDF): Claim Examples for Skilled Nursing Facilities (PT 33) pdf This document provides detailed examples of claim submissions for skilled nursing facilities, emphasizing the correct coding for various services under provider type 33. Understanding these examples is crucial for accurate billing and to avoid claim denials.
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Intermediate Care Services Coding for Skilled Nursing and Intermediate Care Facilities (PT 33) Claim Examples (PDF): Claim Examples for Intermediate Care Services for Skilled Nursing and Intermediate Care Facilities (PT 33) pdf For facilities offering both skilled nursing and intermediate care, this resource clarifies the coding distinctions for intermediate care services under PT 33. Accurate coding is essential to differentiate between service levels and ensure appropriate reimbursement.
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Intermediate Care Services for Intellectually Disabled (IID) (PT 29) Coding and Claim Examples (PDF): Claim Examples for Intermediate Care Services for Intellectually Disabled (IID) (PT 29) pdf Facilities specializing in Intermediate Care for Individuals with Intellectual Disabilities (IID) under PT 29 will find this document indispensable. It outlines specific coding practices and claim examples relevant to the unique services provided in IID settings.
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Supportive Living Program Facilities (SLP) (PT 28) Coding and Claim Examples (PDF): Claim Examples for Supportive Living Program Facilities (SLP) (PT 28) pdf This resource is tailored for Supportive Living Program (SLP) facilities (PT 28), providing coding examples that address the specific billing requirements and service codes pertinent to supportive living environments.
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Specialized Mental Health Rehabilitation Facilities (SMHRF) (PT 38) Coding and Claim Examples (PDF): Claim Examples for Nursing Facilities eligible to be licensed Specialized Mental Health Rehabilitation Facilities (SMHRF) (PT 38) pdf For Nursing Facilities also licensed as Specialized Mental Health Rehabilitation Facilities (SMHRF) under PT 38, this document offers coding guidance and claim examples specific to mental health rehabilitation services, ensuring accurate coding for these specialized services.
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Patient Roster Report Specifications (PDF): Patient Roster Report Specifications (pdf) Accurate patient rosters are essential for billing integrity. This document details the specifications for patient roster reports, which are crucial for verifying patient eligibility and ensuring correct coding alignment with patient information.
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Patient Roster Report Instructions (PDF): Patient Roster Report Instructions (pdf) Complementing the specifications, these instructions provide step-by-step guidance on preparing and submitting patient roster reports, ensuring that the data is accurate and supports the coding and billing process.
Direct Data Entry (DDE) and Coding Accuracy
Direct Data Entry (DDE) is a critical aspect of the billing process. Accurate coding directly impacts the success of your DDE submissions. Ensuring that your staff is well-trained in coding practices is essential for minimizing errors and optimizing payment cycles. Refer to the claim examples and resources provided above to enhance your team’s coding proficiency for DDE.
Technical Assistance for Coding and Billing Queries
We understand that navigating long term care coding and billing can present challenges. To support you, we offer technical assistance calls. These calls are designed to provide real-time support and answer your coding and billing questions directly from HFS experts.
Technical Assistance Calls: April 28, 2017
- All Facilities Technical Assistance Call: 10:30 a.m. – Noon
- Call in Number: 866-233-3842
- Access Code: 420789
While the date above is past, please note that technical assistance calls are periodically announced. Keep an eye on the “Additional Calls” section below for future opportunities to connect with HFS billing experts and address your coding and billing concerns.
Additional Technical Assistance Calls:
To be announced
Webinars for Enhanced Coding Knowledge
Webinars are another valuable resource for staying updated on best practices in long term care coding and billing. While specific dates may be past, the content of these webinars often remains relevant and provides foundational knowledge.
- Webinar April 9, 2019
- Webinar May 18, 2016 (Revised February 2021)
- Webinar May 4, 2016 (Revised March 2020)
- Webinar April 27, 2016 (Revised 01/20/17)
Important Links for Providers
- HFS Home
- Illinois.gov
- JB Pritzker, Governor
- Theresa Eagleson, Director
- xxLong Term Services and Supports
Provider Releases and Updates
Stay informed about the latest policy changes and updates affecting long term care coding and billing through Provider Releases. These releases are your official source for changes that may impact your coding practices and billing procedures. Check regularly for new releases to ensure compliance and accurate claim submissions.
Contact Us for Coding and Billing Support
For any coding or billing related questions or concerns, please reach out to us. We are here to assist you.
Healthcare and Family Services
Bureau of Long Term Care
Billing Unit
201 South Grand Ave East
Springfield, IL 62763
(217)782-0545
(217)557-5061 fax
(844)528-8444 toll free
[email protected]
Accurate long term care coding is the backbone of successful direct billing. Utilize these resources and stay connected with HFS to ensure your facility maintains compliant and efficient billing practices.
