PPS Q&A
PPS Alert for Long-Term Care, August 1, 2010
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to PPS Alert for Long-Term Care.
Q. How do auditors determine what claims to review?
A. Within the past decade or so, contractors have seen a major shift in the way they identify claims for review. Rather than doing reviews of randomly selected claims, CMS requires its contractors to conduct more targeted reviews. To determine what types of claims to target, the contractor must conduct an analysis of data that results in claims filed to the program.
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to PPS Alert for Long-Term Care.
Related Products
-
The Long-Term Care Nursing Assistant's Guide to Advanced Restorative Skills
This book is written specifically for RNAs or nursing assistants to help them provide quality restorative care. Author...
-
Goal-Driven Restorative Nursing:
This 90-minute presentation gives you the information and tools you need to develop and maintain a successful restorative...
-
Nursing and Therapy Documentation in Long-Term Care:
Synchronize resident documentation across multiple disciplines to improve quality of care as well as protect your...
-
The Long-Term Care Compliance Toolkit
It’s just good business sense to have an effective compliance program—but if that’s not enough motivation, the Patient...
-
Medicare Compliance and Risk Management
Under The Patient Protection and Affordable Care Act (PPACA), long-term care facilities are expected to establish a...
Most Popular
- Articles
-
- HIPAA Q&A: Flu shot requirement for hospital employees
- HealthDataInsights posts new issues for medical necessity claims
- Running an effective peer review committee meeting
- Q&A: Incidental disclosures and patient privacy
- Sneak Peek: Effort underway to establish caseload benchmarks
- New FAQ posted on storing laryngoscope blades
- Tip: Perform your own internal investigation prior to government audit
- What does case-mix index mean to you?
- HIPAA 5010 deadline extended, but threat remains, says AMA
- HHS task force: Consider privacy, security with text messages
- E-mailed
-
- Running an effective peer review committee meeting
- HIPAA Q&A: Flu shot requirement for hospital employees
- What does case-mix index mean to you?
- HHS task force: Consider privacy, security with text messages
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Tip: Correctly code bilateral pain management procedures
- 2012 CPT code changes for ASCs: Shoulder and knee scopes and pain management
- COT basics to best
- Documentation and coding for toxic metabolic encephalopathy
- Guidance and tact key to compliant, effective physician queries
- Searched