Consolidated Billing

January 28, 2022


Medicare reimbursement and coverage are complex processes. SNF Consolidated billing is often not well understood by Skilled Nursing Facility Medicare team. It is critical for each Medicare team member to grasp the concepts of Consolidated Billing and have the tools and resources to ensure that federal regulations are followed and that accurate billing is being completed. This webinar will review the five major categories of the exclusions to Consolidated Billing along with the specific requirements for each category. New Consolidated Billing exclusions that began 1/1/2022 will be reviewed. The SNF’s financial responsibility for resident transports (ambulance vs. non-ambulance transport) will also be discussed.

Learning Objectives:

  1. The Medicare team would correctly inform residents and resident families about the services paid for and provided by Medicare during the skilled stay in the SNF.
  2. NHAs and the Medicare team would recognize the financial costs associated with new Medicare admissions to identify ways to make the stay most cost-effective for the SNF.
  3. The Medicare team will recognize their responsibility to communicate with outside providers, informing them of the resident’s payer status, when Medicare A residents receive outside services during their skilled stay.
  4. The Medicare team will work with the billing department to ensure federal regulations are followed concerning consolidated billing.



Carol Maher is a Board Certified Gerontological Registered Nurse with over 30 years of long term care experience and has worked in long term care in many roles. She worked as the MDS Coordinator in a 300 bed SNF in Pennsylvania for 8 years before moving to CA to become the MDS Coordinator/Director for a 1200 bed SNF in San Francisco. She has also worked as the MDS Coordinator in a SNF that typically had 60-75 residents on Medicare in addition to 160 long-term care residents. Most recently she was the Senior VP of Utilization Services and Director of Reimbursement for large multi-facility organizations.

Carol has worked as one of the Gold Standard nurses for MDS 3.0, serving on the RAP workgroup to prepare the way for the CAAs for MDS 3.0, and participating on a number of Technical Expert Panels related to MDS, Quality Measures and care planning. A sought-after speaker, she has given presentations at AANAC, AHCA and Leading Age national conferences as well as many state organization presentations. She is also a frequent author of articles related to the RAI process and PPS. Carol served as a member of the AANAC Board of Directors for 9 years. She is presently serving as the chair of the AANAC Expert Advisory Panel and as an AANAC Master Teacher of the RAC-CT and RAC-CTA certification courses. Ms. Maher is the Director of Education for Hansen Hunter & Co. P.C., providing MDS and Medicare classes across the country, presenting monthly educational webinars and completing compliance audits. She is the author of Long-Term Care MDS Coordinator’s Field Guide (HCPRO 2016).

Credit Hours

  • 1 credit hours for RNs
  • 1 credit hours for NABs

This pre-recorded webinar expires on August 13, 2022.


Hansen Hunter & Co. P.C. clients are invited to access any of our webinars for free by contacting Allison Johnson at our office at 503.244.2134 to receive your free registration code.


  • This nursing continuing professional development activity was approved by Montana Nurses Association, an accredited approver with distinction by the American Nurses Credentialing Center’s Commission on Accreditation.
  • Enduring material: To meet the requirements for these contact hours, you must watch the entire recorded presentation as well as answer and submit the post-test evaluation that is provided as a link along with the link to your webinar which you will receive via email after completing your purchase.