Certified Revenue Cycle Representative (CRCR) Practice Exam

If a patient is an inpatient of an SNF for more than 30 days, what is the SNF permitted to do?

1. Submit interim bills to the Medicare program

2. Request a patient transfer

3. Negotiate with secondary payers

4. Change the patient’s care plan

The correct answer is: Submit interim bills to the Medicare program

The correct choice reflects the specific billing practices allowed for skilled nursing facilities (SNFs) when a patient has been under their care for an extended period of time, particularly beyond 30 days. In this scenario, submitting interim bills to the Medicare program is permitted to address ongoing costs associated with long-term stays. This helps the facility manage cash flow and ensures that reimbursement is received for the services rendered to the patient during their stay. It provides a mechanism for the SNF to claim partial payments based on the length of the patient's stay and the services provided before a final bill is submitted once the patient is discharged. The other options, while related to care and financial aspects of patient management, do not align with the specific guidelines relevant to SNFs regarding billing practices. For instance, requesting a patient transfer or changing the care plan involves clinical decisions and patient management rather than billing procedures. Negotiating with secondary payers is also a standard practice but is not a direct result of the timeframe that the patient has been an inpatient; rather, it concerns coordination of benefits.