US · guidance
CMS Pub. 100-04, ch. 6, § 40.1
Submit Bills in Sequence
SNF-517.13, A3-3603.2
The SNFs must submit bills in sequence for each beneficiary they service. The A/B
MAC (A) will return to the SNF a continuing stay bill if the prior bill has not been
processed. When the A/B MAC (A) receives an out-of-sequence claim for a continuous
stay, it will search its history for the prior adjudicated claim. If the prior bill has not been
finalized, the A/B MAC (A) will return to the provider (RTP), the incoming bill, request
that the prior bill be submitted first, and the returned bill only be submitted after the SNF
receives notice of adjudication of the prior bill. A typical error message follows:
Bills for a continuous stay or admission must be submitted in the same
sequence in which services are furnished. If the provider has not already
done so, please submit the prior bill. Then, resubmit this bill after you
receive the remittance advice for the prior bill.
If the prior bill was submitted, the SNF will hold the returned bill until it receives a
remittance advice for the prior bill.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
41623c74027742cb0c09c0aa62e1e5f7cf63e4e14e14caf193eb929b0fbbc915
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