Medicare Claims Processing Manual (Pub. 100-04), Ch. 6 § 80.7

Establishing That a SNF Qualifies to Receive Part B Payment on

Last amended: 2003Year: 2003Length: 234 wordsOfficial source
80.7 - Establishing That a SNF Qualifies to Receive Part B Payment on the Basis of Reassignment (Rev. 1, 10-01-03) SNF-512 A SNF wishing to receive Part B payment as a reassignee of one or more physicians must furnish the A/B MAC (B) sufficient information to establish clearly that it qualifies or does not qualify to receive payment for their services. Where there is any doubt that a SNF qualifies as a reassignee, A/B MACs (B) will obtain additional evidence. In some cases, a SNF may qualify to receive payment for the services of a physician both as the employer of the physician and as the facility in which the services are performed. As soon as it is determined that a SNF can qualify on either basis, no further development is undertaken with respect to that physician or to other physicians having the same status, and reassigned claims submitted by the SNF for services furnished by those physicians are honored. However, where other physicians have, or appear to have different status, further development is required. It is possible in some instances that a determination is made that Part B payment can be made only to the physician himself. Where the SNF qualifies as a reassignee, it assumes the same liability for any overpayments that it may receive as a reassignee as the physician would have had if the payment had been made to him/her.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 6 § 80.7: Establishing That a SNF Qualifies to Receive Part B Payment on | Justis AI