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Expedited Determinations Clarified

By Caralyn Davis, Staff Writer - June 20, 2018

Financial liability notification requirements are front and center right now thanks to the implementation of the revised Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN) for traditional fee-for-service Medicare Part A skilled care. However, providers still have to fulfill the completely separate notification requirements of the two-stage expedited-determination process for residents who haven’t exhausted their benefits, but whose skilled care is about to end under Medicare Part A, Medicare Part B, or Medicare Advantage, says Stacy Baker, OTR/L, RAC-CT, director of audit services for Proactive Medical Review & Consulting in Evansville, IN. That point recently has been driven home in two ways: