QUIZ: 2023 Compliance, Audits and Beneficiary Notices

What are the main purposes of the Beneficiary Notices issued to residents in the SNF? (Check all that apply)

The Beneficiary Notice given to residents who have an end in their Medicare Part A coverage because the facility states the coverage is no loner medically necessary is…

The main purpose of the NOMNC – Notice of Medicare Non-Coverage is all EXCEPT

If a resident cut from Medicare Part A decides to appeal the facility’s decision, what form must the facility issue and what is on the form?

The primary purpose of any of the Advanced Beneficiary Notices (ABN’s) is….

A resident cut from Medicare Part A and issued a NONMC who will be staying in the facility long term, or for at least 1 additional day after Medicare ends, needs to be issued an additional document. Which one?

The Beneficiary Notice required for residents coming off all Part B therapy programs is called the NOMNC. This form gives the resident 2 days advanced notice and allows for them to appeal the decision.

The only reason a facility would issue the CMS ABN-R-131 to a Medicare Part B resident is if the resident requested continued services after the therapist determined they were no longer medically necessary AND the facility decides to provide additional services. 

Medicare Part A and Part B residents are selected for medical reviews based on data patterns that trigger the need for further review.

Both SNF Providers and SNF residents are entitled to appeals of denied claims or services. How many levels are in the Appeals Process?