Facility Billing

Facility billing means enterprise billing which is including the payment process for the Distribution Service. However, facility billing has made distribution service available by Oppizi to the client through which the client will make the payment of the distribution fees with the payment due from the Client according to a statement that is delivered by Oppizi every month to the client.

  • Distribution Fees contain the charge incurred by the client to the Distribution Providers for the other Distribution Services those obtained by the use of Marketplace Services, And mainly authorized by the client to be paid by way of facility billing.

Skilled Nursing Facility Billing

In the dark red font, you will find the substantive content updates. This educational tool helped to get the detail about the skilled nursing facility (SNF) & Swing bed Coverage. Also, it will provide you the complete knowledge about the billing and payment requirements.

  • Within 30 days, the Medicare patients are re-admitted
  • Billing when benefits exhaust
  • No-payment billing
  • Non-covered days in the billing

Skilled Services

According to the physician orders skilled care nursing is provided:

  • To those who require skilled or qualified technical or professional health personnel for example registered nurses, licensed practical nurses, occupational therapists, physical therapists, and speech-language pathologists or audiologists.
  • Medicare is provided directly under general skilled nursing or skilled rehabilitation personnel supervision which assures the patient’s safety and medically desired results.

Coverage Requirements

Following are the conditions that the original Medicare enrollee must meet these conditions to qualify for (The skilled Services) Process.

  • At least 3 consecutive calendars days the patient was a hospital inpatient for medically necessary stay.
  • After the hospital discharge patient was transferred to Medicare-Certificate Skilled Service Feature within 3 consecutive days.
  • The 3-day stay may waive for enrollees is included in the advantage of the medicare plan.
  • Only in the SNF on an inpatient basis the daily skilled services can happen.
  • During the reasonable duration and quality of the services it is reasonable and necessary for diagnosing and treating a patient’s qualifying condition.

  3-Day prior Hospitalization 

A patient meets 3 consecutive-day stay requirements just by staying 3 consecutive days in one more hospital. Note that the time spent in observation or the emergency room before admission doesn’t count toward the 3-day qualifying inpatient stay in hospitals.

  3-Day Stay Waiver 

Mostly SNFs that have a relation to the Shared Saving Program may waive the SNF 3-day rule.

Advantage Plans of Medicare

Typically MA plans, PACE plans or 1876 cost plans have the 3-days hospitalization requirements. As Original Medicare covers, MA plans must cover the same number of SNF days or may be covered more.

  • MA Plans offers different beneficial periods
  • Including the SNF coverage, each Evidence of Coverage describes all SNF coverage.

Benefit Period

We consider the SNF coverage as a beneficial period. The benefit begins with the day from which a patient admits to a hospital or SNF as an inpatient.

A new benefit period begins when a patient admits to a hospital SNF, once a benefit period ends.

Related Billing Facilities

Following are the facilities that are provided to the patient who is taking the Medicare services or facility billing services.

  • Processing Facility
  • LNG Facility
  • Vending Facility
  • Tanning Facility
  • Canais Processing Facility
  • Generating Facility
  • Outsourcing Facility
  • Recycling Facility
  • Dry cleaning Facility, etc.