Post-Pay Reviews Start for SNF Claims Using 3-Day Stay Waiver

Post-pay auditing has begun for skilled nursing facility (SNF) claims which utilized the 3-Day Stay Waiver allowed by the Centers for Medicare and Medicaid Services (CMS) in response to the public health emergency (PHE). Providers who used the waiver to cover in-house residents are most at risk for audit.

Noridian, as the national Supplemental Medical Review Contractor (SMRC) for CMS, is conducting post-payment reviews of Medicare Part A SNF claims nationwide, on dates of service from March 1, 2020, through December 31, 2021. In particular, the SMRC is performing reviews of SNF claims that had zero hospital stay days prior to admission.

Celtic offers support to providers that receive Additional Documentation Requests (ADR). Our associates are subject matter experts in Medicare regulations and provide guidance for responding to ADRs, and recommendations for further action.

Contact us today to discuss your options.

About Lauren Videtto