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MDS 3.0 Insider
MDS 3.0 Insider goes beyond the regulations and provides real-world advice and tips to help you evaluate your processes to help you implement a smooth transition to MDS 3.0. We can help you.
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Issue 1, January 5, 2018
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MedPAC comments on CMS’s proposed rule on Medicare Part C and Part D
On January 3, 2018, MedPAC commented on CMS’ proposed rule for Medicare Part C and Medicare... -
Achieve Up to $63K in Cost Savings
SNF occupancy rates continue to trend downward. The National Investment Center for Senior Housing... -
New Medicare Card Project Special Open Door Forum
Join CMS on Tuesday, January 23 from 2:00 to 3:00 pm ET for a special open door forum. This call... -
New voluntary bundled payment model announced
On January 9, CMS’ Innovation Center announced the launch of a new voluntary bundled payment... -
CMS proposes Medicare Advantage and Part D payment and policy updates
On February 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released proposed... -
Training strategies to help overcome common collections challenges
There are strategies you can implement to help overcome common collections challenges. Becky... -
Two-year budget deal repeals therapy caps, cuts skilled nursing spending by $1.96 billion
Last week, President Donald Trump signed a two-year federal budget deal that left long-term care... -
Understanding phase 2 requirements for survey readiness
A thorough review and update of the implementation of Phase 2 requirements, as well as preparation... -
Ethical principles for long-term care billers
The following ethical principles are based on the core values of The Billers’ Association for... -
New CMS policy could change inpatient rehab denial trend
In the past, Medicare contractors have been allowed to deny a claim for inpatient rehab if the... -
Updated 2018 Medicare Part B physician fee schedule in effect
As part of the Bipartisan Budget Act of 2018 signed into law by President Trump on February 9... -
CMS says this is number one reason for Medicare denials, publishes provider tips
In a recently published MLN fact sheet, CMS announced that the majority of SNF service improper... -
Submit comments on IMPACT Act quality measures by May 3, 2018
To satisfy requirements of the Improving Medicare Post-Acute Care Transformation Act of 2014... -
CMS raises Medicare Advantage pay rates by 3.4% for 2019
In a final rule published on Monday, April 2, 2018, CMS announced 2019 payment updates for Medicare... -
Download your new SNF PEPPER report
The Q4FY17 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns... -
CMS reduces reimbursement by 13% for non-emergency BLS ambulance transports to and from renal dialysis treatment
In an MLN Matters article published on April 6, 2018, CMS announced a 13% reduction in ambulance... -
Payroll-based journal data goes live on Nursing Home Compare
Staffing data submitted to CMS in accordance with the agency’s payroll-based journal... -
CMS makes major revisions to RCS model, introduces new proposed Patient-Driven Payment Model
Many concerns and questions from stakeholders followed the introduction of the Resident... -
Should traditional Medicare cover chronic care?
Considering adding chronic care as a benefit under traditional Medicare coverage started with the... -
President "will keep turning up the pressure" until pharmaceutical industry puts patients first
During remarks on President Trump’s drug pricing blueprint held in Washington, D.C. earlier... -
New white paper: Using collaboration to achieve accurate diagnoses claims
The American Health Information Management Association’s definition of principal/first... -
Proposed payment rule PDPM: What SNFs need to know
Expert guest post: The Patient-Driven Payment Model (PDPM), as proposed, is designed to replace the... -
Compliance tip: The relationship between the assessment and the claim
Each scheduled SNF Medicare assessment is used to support Medicare PPS reimbursement. The scheduled... -
Documentation terminology that will not support the Medicare claim
Documentation should be precise and specific for each resident. General terminology that is not... -
New Medicare cards: What's that square code?
CMS published an announcement explaining that some of the new Medicare cards may have a square... -
Review your performance data before July 1!
CMS has updated SNF Provider Preview Reports and they are available for review. Providers have... -
CMS promises targeted Medicaid audits, stricter enforcement
While touting the need for partnership between states and the federal government, the Centers for... -
Consolidated billing stage-specific strategies for compliance
Failure on the part of the SNF to fulfill its Medicare program obligations. Whether it’s... -
CMS seeks public comment on new proposed Medicare application process
CMS announced plans to streamline the Medicare application process for providers by making changes... -
Medicare physician fee schedule: What's changing for 2019?
On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule... -
SNF PPS final rule published, new payment model to begin October 1, 2019
It’s official: According to CMS’ Skilled Nursing Facility (SNF) Prospective Payment... -
Two strategic responses to bundled payment models
Medicare's bundled payment programs are profoundly impacting the way acute-care providers are... -
Resources for a smooth transition to PDPM
As SNF and nursing home providers familiarize themselves with CMS’ new Patient Driven Payment... -
CMS makes several Medicaid announcements, including new audits and requirement for budget neutral demos
In a statement made my CMS administrator Seema Verma dated August 21, 2018, it was announced that... -
Understand the SNF UB-04 data elements for Part B billing
There are multiple data requirements for the UB-04. Each line contains a form locator (FL), and a... -
Combing patient records for additional diagnosis codes reaps massive returns for Medicare Advantage plans
Under traditional Medicare in a SNF, diagnosis codes don’t have a significant impact on... -
Seven tips for reviewing and responding to PEPPER reports
Every April, CMS makes the Program for Evaluating Payment Patterns Electronic Report (PEPPER... -
New Medicare card update
CMS has confirmed that they are processing claims and eligibility requests with the Medicare... -
Updates to MDS 3.0 FY2019
Changes to the Minimum Data Set (MDS) for skilled nursing facilities (SNFs) for the fiscal year... -
Your Medicare Advantage plan may be inappropriately denying payments
The following is an excerpt from Revenue Integrity Insider, Volume 2, Issue 25 Medicare... -
Trump administration's proposed rule aims to penalize legal immigrants for using Medicaid
The Trump administration’s proposed rule issued on Wednesday raises concerns about the health... -
CMS releases 2019 Medicare Parts A&B premiums and deductibles
On October 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019... -
Five newly published measures on Nursing Home Compare
Earlier this week CMS published data from five new quality measures on Nursing Home Compare (NHC... -
These 7 readmission risks could prevent you from receiving SNF VBP incentive payments
As of October 1, 2018, the Skilled Nursing Facility (SNF) Value-Based Purchasing Program (VBP... -
Providers worry that proposed rule could cut Medicaid revenue
The CMS is drafting a proposed rule that would give states greater flexibility in paying (or not... -
Privacy concerns for the business office
The following is an excerpt from an article that originally appeared in the October 2018 issue of... -
Verma says drop in improper payment rate is result of "focused effort to target root causes"
CMS reports that the 2018 Medicare fee-for-service improper payment rate is at its lowest since... -
Q&A from Biller’s Talk
Q: This is my first time billing for the flu shots, can we add them to our Part A and Part B... -
Featured member resource: HIPAA authorization form
Securing resident health information should be an ongoing effort that is constantly evaluated for... -
Op ed: Are postacute, site-neutral payments the future?
Editor’s note: The following is reprinted with permission from a post on Reg’s Blog... -
Submit your PDPM questions to CMS for December 11 call
CMS will hold an informational call on December 11 at 3:00pm, ET, to help providers prepare for the... -
KX modifier amounts announced for CY19
The annual per-beneficiary incurred expense amounts are now known as the KX modifier thresholds... -
Billers’ Association 2019 quarterly webcast dates available, register now!
As part of your Billers’ Association for Long-Term Care (BALTC) membership, you have access... -
Providers have "affirmative duty" to check updated LEIE database
Providers are encouraged to check the US Department of Health and Human Services, Office of... -
RCS-1: What?s changing and how will you be affected? Part 2
While RCS-1 has not been finalized, providers can anticipate a whirlwind of change beginning as... -
New voluntary bundled payment model
On January 9, 2018, CMS’ Innovation Center announced the launch of a new voluntary bundled... -
Tips to win an appeal
Without every “i” dotted and every “t” crossed on a claim, an overpayment... -
2017 Index; find everything you’re looking for!
Looking for a specific article? All of your 2017 BALTC articles, indexed in one place, just for... -
OIG investigations to keep in mind in 2018
In the Office of Inspector General's (OIG) FY17 Work Plan, the agency outlined its plans for 2017... -
Have you signed up for our next quarterly webinar?
Join Stefanie Corbett, DHA, as she discusses payment reform in 2018. Need more insight into the... -
Have you heard? We've added a NEW Administrator's Bootcamp!
The Long-Term Care Administrator’s Boot Camp offers skilled nursing facility administrators a... -
Did you miss our quarterly webinar?
No problem! Access the recording here. Stefanie Corbett, DHA, discussed payment reform in 2018... -
Resources for preparing vaccine claims
Vaccinating residents against the flu is an annual initiative. Every year, SNF business offices are... -
RCS-1 draft model calculation worksheet
SNF providers are on the edge of their seats as they anticipate CMS’ consideration of a... -
CMS now conducting on-site and off-site PBJ audits
CMS has released public use files (PUF) containing staffing data submitted by long-term care... -
Billers instructed to review CMS updates to Medicare policy manuals
In an MLN Matters article dated March 16, 2018, CMS instructed providers to make sure their billing... -
How does the EHR support QAPI?
The key function of any EHR is to collect data, followed closely by a reporting function. These... -
Look out for new Medicare cards in the mail
CMS started mailing newly-designed Medicare cards with the new Medicare Beneficiary Identifier... -
Scrutinizing Medicare coverage for physical, occupational and speech therapy
For years, confusion has surrounded the conditions under which older adults can receive physical... -
CMS publishes revised instructions for consolidated billing related to ambulance transportation
CMS published clarification earlier this week on coverage of an ambulance transport for a SNF... -
New tax rule could save SNFs thousands annually
In a white paper dated April 16, 2018, the American Health Care Association (AHCA) and the National... -
Tips to avoid improper payments for lower limb orthoses
CMS recently reported that the Medicare Fee-For-Service (FFS) improper payment rate for lower limb... -
CMS call to clarify qualified Medicare beneficiary (QMB) program billing requirements
On Wednesday, June 6, from 1:30 to 3:00 pm ET CMS experts will discuss the QMB billing requirements... -
Medicare to pay more for DME services
On May 11, CMS published an Interim Final Rule with Comment Period in the Federal Register... -
Medicare's prior authorization program may continue under GAO recommendation
Beginning in 2012, CMS introduced prior authorization to the Medicare program, which requires... -
Providers encouraged to review eligibility requirements for expanded dispute resolution process
Earlier this month CMS explained an expansion of the Office of Medicare Hearings and Appeals&rsquo... -
SNF provider preview reports now available, review before June 30
Skilled Nursing Facility (SNF) Provider Preview Reports have been updated and are now available... -
Reimbursement increased by 77% for brand-name Part D drugs
According to a report published by the OIG this month, total reimbursement for all brand-name drugs... -
CMS issues guidance for handling insufficient documentation, ADRs
CMS issued change request (CR) 10778 on June 15, with an effective date of July 17, to update... -
Interoperability and post-acute implications
CMS stance/policy on interoperability among providers and the resultant debate are rather... -
Claims for Medicare Diabetes Prevention Program services being denied
CMS recently clarified that Medicare Administrative Contractors are rejecting claims for Medicare... -
SNFs found to be out of compliance with QRP requirements will receive letter from CMS
CMS is providing notifications to facilities that were determined to be out of compliance with... -
Did you miss our live webinar, PBJ Updates, July 2018?
Listen to our on-demand version any time! Postacute regulatory specialist Stefanie Corbett, DHA... -
HCPCS codes used for SNF consolidated billing updated
CMS published an MLN Matters article this week announcing an update to the lists of Healthcare... -
CMS to present an overview of the Medicare Secondary Payer Recovery Portal
The Medicare Secondary Payer Recovery Portal (MSPRP) is a web-based tool designed to assist in the... -
FY 2019 release of ICD-10-CM now available
The National Center for Health Statistics recently released the 2019 ICD-10-CM Official... -
CMS administrator aims to make doctors' offices a "fax free zone" by 2020
During the ONC’s Interoperability Forum in Washington, D.C. this month CMS administrator... -
Question from your peers
Q: We have a patient that was in the hospital for one week. The patient went to another skilled... -
Stark law reform push sees movement on multiple fronts
The window closed Friday night for public comments on a Centers for Medicare & Medicaid... -
Billing Q&A
Q: If a Part A resident received services from an outside vendor—such as x-rays—and... -
SNF final rule: Prepare for PDPM
CMS’ final rule, effective in October 2019, is a major overhaul for the long-term care... -
Billers' Association members, have you signed up for our quarterly webinar?
Join us on Wednesday, October 3, 1-2pm, ET for our quarterly Billers’ Association for... -
CMS seeks billing specialists to participate in provider compliance focus group
The Centers for Medicare & Medicaid Services (CMS) is seeking billing specialists to... -
CMS publishes corrections to RUG-IV federal per diem rates & MDS item in SNF PPS final rule
The Centers for Medicare & Medicaid Services published the following summary of errors... -
Did you miss our quarterly webinar? Here's how to listen.
If you couldn’t attend the Billers’ Association for Long-Term Care’s quarterly... -
Two jurisdictions announce new Targeted Probe and Educate topic
The MACs for the J5 (Iowa, Kansas, Missouri, and Nebraska) and J8 (Indiana and Michigan... -
Q&A from Biller's Talk
Q: If a resident has a United Healthcare Medicare Advantage Plan and wants to disenroll from it and... -
CMS final rule makes changes to how physicians are paid, delays E/M coding reform
As part of a final rule published by CMS yesterday to reduce provider burnout, the implementation... -
Healthcare winners and losers from election night 2018
Source: HealthLeaders The 2018 midterm elections are over but made a significant impact on... -
Featured question from Biller's Talk
Q: A patient came in from the hospital. The patient was admitted to Medicare Part A and was... -
Civil monetary penalties to fund new CMS quality improvement initiative
CMS announced a three-year quality improvement initiative in a press release on November 20, 2018... -
Case study: Consolidated billing, major category I
Background: To illustrate the different billing requirements that apply to professional and... -
GAO: New payment rates for Part B lab tests may lead to billions in overpayments
This post originally appeared on December 10, 2018 in Revenue Cycle Advisor. Medicare’s... -
Special requirements for billing urology supplies & updated DMEPOS fee schedule
Medicare covers urinary catheters and external urinary collection devices when they are used to... -
Are you up to speed on the new evaluation and reevaluation codes?
On January 1, 2017, two significant changes went into effect in the therapy world: The Centers for... -
New voluntary bundled payment model announced
On January 9, CMS’ Innovation Center announced the launch of a new voluntary bundled payment... -
Have you heard? We've added a NEW Administrator's Bootcamp!
The Long-Term Care Administrator’s Boot Camp offers skilled nursing facility administrators a... -
We know that your role is anything but easy...
Which is why we worked with billing experts Janet Potter, CPA, MAS, and Frosini Rubertino, RN, BSN... -
Get the revised SNFABN and instructions, mandatory for use beginning May 7
CMS has released a newly revised skilled nursing facility advanced beneficiary notice (SNFABN... -
Five essential resources for navigating the Medicare appeals process
When the MAC denies a claim, the SNF has the option to appeal the decision through the appeals... -
Have you heard about our new Long-Term Care Advisory Services?
Let us connect your long-term care challenges and questions to an unrivaled network of experts... -
CMS published additional instructions for processing updated Part B therapy claims
Earlier this month CMS posted the updated Medicare Part B fee schedule that changed with the... -
Don't miss our quarterly webinar on Wednesday, April 18! Spice Up Your Compliance Program with PEPPER Reports
Join us on Wednesday, April 18, 2017 at 1:00pm EST for our quarterly webinar with Stefanie Corbett... -
Have questions about consolidated billing? Check out our new white paper!
Since its introduction in the SNF setting, consolidated billing has been one of the most routine... -
Did you miss our quarterly webinar?
Not to worry! Click here to access the recording. HCPro’s postacute regulatory specialist... -
Calling all experts! Get involved in educating other long-term care professionals.
The Billers’ Association is seeking long-term care managers, revenue cycle enthusiasts, and... -
How is your QM data affecting your survey?
Join postacute regulatory specialist Stefanie Corbett, DHA, for our 60-minute webinar on Thursday... -
Streamline consolidated billing claim submission with this tool
Looking for guidance on consolidated billing claim creation and validation efforts? Click here for... -
Increase revenue savings by eliminating this common error
Effective October 1, 2018, drug regimen review (DRR) will be a quality measure in the SNF Quality... -
Interactive tutorial for completing the ABN now available
The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, should be used by skilled... -
New Medicare card mailing update
CMS has started mailing new Medicare cards to people with Medicare who live in Wave 2 states and... -
What are you doing in August?
Join us in Chicago on Monday and Tuesday, August 13-14, to attend our SNF Regulatory Update Boot... -
What should your policy for coding compliance and ethics include?
Coding continues to be a prime target for audits because errors, gaps, and missing information are... -
A tool for your CNAs to help with accurate ADL documentation
The SNF PPS establishes a schedule of Medicare assessments, and each assessment supports... -
Three new regulatory requirements that implicate service contracts
Having effective contracts in place in your facility can help minimize regulatory and financial... -
Have you signed up for this quarter's webinar?
Beginning June 1, 2018, CMS will no longer collect facility staffing data through the CMS-671 form... -
Verify claim accuracy for ICD-10
Claims errors are the number one reason for additional development requests (ADRs) and a major... -
CMS Special Open Door Forum: The IMPACT Act and standardized patient assessment data elements
CMS will be hosting a Special Open Door Forum (SODF) on July 25, 2018 from 2:00-3:00pm, ET. This... -
Flowcharts to help you with the Medicare appeals process
Once an initial claim determination is made, beneficiaries, providers, and suppliers have the right... -
What are the experts saying about PDPM?
If you’ve been paying attention to the progression of CMS’ new payment system to... -
Sign up for our free webinar: Ready or Not: PDPM is Here
Join HCPro’s postacute regulatory specialist Stefanie Corbett, DHA, on Wednesday, August 22... -
[NEW WHITE PAPER] Tackling common billing challenges with case studies
This quarter’s Billers’ Association for Long-Term Care white paper includes several key... -
[WEBINAR] Consolidated billing: How new payment reform affects SNFs
The final payment rule for SNFs is here. Under the Patient-Driven Payment Model (PDPM), SNFs can... -
Upcoming CMS open door forums
CMS has three open door forums coming up in September:CMS has three open door forums coming up in... -
CMS releases updates to billing for flu vaccine
Flu season is August to April. Make sure you’re prepared to start billing for the influenza... -
Update to Medicare Claims Processing Manual, Chapter 23, Section 60.3
For newly covered DMEPOS items paid on a fee schedule basis where a Medicare fee does not exist... -
New HCPCS code, Q5110, effective October 1, 2018
A revised MLN Matters article regarding updated healthcare common procedure coding system (HCPCS... -
CMS invites Medicare Part A providers to learn new Medicare Cost Report e-filing system
Register for Medicare Learning Network events. Medicare Part A providers: Learn how to use the new... -
CMS publishes 2016 SNF PUF data
CMS has posted the fourth release of the Skilled Nursing Facility Public Use File (Skilled Nursing... -
MedPAC publishes resource for SNFs: Payment basics
MedPAC released their Payment Basics for SNFs 2018 report, which provides an overview of Medicare... -
Feature free resource
Special report: Trackling common billing challenges Learn how to tackle the most common billing... -
New white paper available
Download The Billers’ Association fourth quarter white paper: An in-depth look at how... -
10 new free resources for SNF billers
The Billers’ Association for Long-Term Care provides members with a resource of continuously... -
Featured member resource: MDS chart audit tool
The purpose of the MDS chart audit tool is to ensure documentation is present in the medical record... -
Featured member resource: ADR appeal documentation checklist
Upon receiving a request for additional documentation or when filing an appeal, a copy of the ADR... -
Frequently asked questions about Medicare Part B
Q: How should multiple units of the same HCPCS code given on the same day be listed on the UB-04... -
New member resource for your compliance & ethics program
As a result of updated survey protocols published in Appendix PP of the State Operations Manual on... -
Seeking speakers for 2019 Revenue Integrity Symposium
The National Association of Healthcare Revenue Integrity (NAHRI) is currently seeking speakers to... -
The quintessential form for the business office and administrators
Anyone involved in billing and reimbursement in a long-term care facility is likely very familiar... -
The 2018-2019 SNF outlook
As 2017 closed, a number of projects kept me busy right up to the Christmas holiday. Among them was... -
New Medicare Card Rollout
CMS has announced that they will mail the first group of the new Medicare cards to Medicare... -
Spice up your corporate compliance and ethics program with PEPPER
Every spring, CMS makes available the Program for Evaluating Payment Patterns Electronic Report... -
New Medicare card project special open door forum March 20
CMS will host a Special Open Door Forum to give providers an opportunity to ask questions about the... -
Care plans: How they affect compliance and reimbursement across the entire facility
In 2013, several OIG studies and investigations found that SNFs had deficiencies in quality of... -
The medical review department chose to conduct a postpayment review...now what?
There are two main types of medical reviews, sometimes called “probes”: ... -
Revised SNF ABN mandatory for use beginning this May
In January of this year, the Centers for Medicare & Medicaid Services (CMS) released a newly... -
Q&A: Goodbye RUG-IV, hello RCS-1: Preparing for quality under a proposed payment system
Q: I have heard that the transition to the Resident Classification System, version 1 (RCS-1) will... -
Have you joined the Biller?s Talk listserv yet?
Did you know that as a Billers’ Association member, you have access to a community of billers... -
Have you registered for our billing boot camp yet? Members get 10% off!
Our Skilled Nursing Facility Billing Boot Camp kicks off Monday, May 14 to May 15 in Chicago, IL... -
SNFs and the Medicaid conundrum
What do Morningside Ministries, Genesis Healthcare, Signature Healthcare, HCR ManorCare, and... -
Patient-driven payment model, survey, and quality: Understanding MDS accuracy and what you need for success
On Friday, April 27, 2018, the Centers for Medicare & Medicaid Services (CMS) published a... -
Q&A: Post-Medicare audit processes
Q: What should we do if we feel that the auditor’s findings are blatantly wrong? A: If it... -
ICD-10 FY2019 procedure codes and other CMS updates
Click on the links below to view recent MLN memos regarding coding updates for long-term... -
Managed care admissions: Bridging the communication gap between admissions and the business office
Due to the complex nature of managed care (MC) insurance as compared to traditional Medicare, staff... -
New proposed payment system, part I: Case-mix components drill-down
With the release of the proposed rule on April 27, 2018, the Centers for Medicare & Medicaid... -
How PBJ staffing data can affect your bottom line
Payroll-Based Journal (PBJ) data submitted to the Centers for Medicare & Medicaid Services... -
Full speed ahead: Assess and improve your work culture to achieve revenue integrity
Collaborative, challenging, and fast-paced: These are just some of the words that NAHRI members use... -
Case studies and scenarios: Various types of audits
Most audits are conducted in very similar manners. They also determine their focus using very... -
Medicare is the secondary payer: Now what?
While Medicare is most often the primary payer for Medicare beneficiaries, some beneficiaries are... -
New proposed payment system, Part 2: Changes to the RAI process
The Centers for Medicare & Medicaid Services’ (CMS) new proposed payment system, the... -
Billers' Association members, take our 10-minute member survey!
Billers' Association members, we want to hear from you! Take our 10-minute survey for a chance to... -
PPD as the benchmark for measurement
In long-term care, especially within the nursing home sector, per patient days (PPD), a financial... -
Emphasis on shorter lengths of stay may cause identity crisis among long-term care facilities
Beneficiary enrollment in Medicare Advantage plans is on the rise, increasing from 5.3 million in... -
Consolidated billing: Navigating special cases
Oftentimes, claim rejections and negative outcomes from billing compliance audits are results of... -
LTC nurse residency results in: 86% retention rate
Postacute care has become an essential component of value-based care. By preparing new nurses... -
Biller's talk Q&A: Questions, concerns, and solutions from your peers
See what your peers have been talking about: We’ve compiled some of our members&rsquo... -
10 things you need to know about CMS? final SNF PPS rule, and PDPM
It’s official: According to CMS’ Skilled Nursing Facility (SNF) Prospective Payment... -
Calculating reimbursement under PDPM
Many staff members in a skilled nursing facility (SNF) have contributed to the minimum data set... -
Self-disclosure can alleviate--not eliminate--penalties for fraudulent claims
The interplay of Medicare billing and fraud seems like a perennial hot spot among SNFs. When an... -
Key documentation criteria for supporting the Medicare claim
Medicare documentation must provide accurate information to support the necessity of skilled... -
Q&A: Getting to know PDPM
Q: When will the reimbursement rates begin decreasing? A: After the 20th day of a... -
Billing for the flu vaccine
As clinical teams work diligently to educate their residents about the flu, and offer and/or... -
Are you billing Occurrence Code 22 correctly?
In an MLN Matters article issued on October 5, 2018, CMS described systems changes they made to... -
473 changes: Cracking the code
Coding tells the detailed story of your facility’s patient care, morbidity, and sometimes... -
The RACs’ role in identifying over- and underpayments
The Recovery Audit Program’s mission is to identify and correct Medicare improper payments... -
Reducing accounts receivable and improving collections: A success story
Deborah Collum, national director of revenue cycle management for Covenant Retirement Communities... -
Achieve accurate reimbursement and compliance with these best practices
A best practice is a technique or methodology that, through experience and research, has proven to... -
Reporting physician visits for SNF patients
by Peggy S. Blue, MPH, CPC, CCS-P, CEMC This article has been republished from... -
ICD-11 is here and U.S. is mulling its use for mortality reporting
by Laura Evans, CPC As coders mark the third anniversary this October of the U.S. implementation... -
’Tis the season for SNF leaves of absence, are you prepared?
In preparing for the holiday festivities, it is essential for friends and family to understand that... -
Tools to conduct an admission audit on your facility
An admission audits generally occurs five days after an admission (not too early/not too late). The... -
Q&A: Reducing readmissions to meet SNF VBP requirements
Q: A patient is discharged from the skilled nursing facility (SNF) on day 24 and sent home to... -
Optimizing Managed Care Partnerships to Maximize Clinical Outcomes
Q. When sharing patients’/residents’ functional outcomes with your managed care... -
MedPAC advises CMS to establish payment equity between postacute care settings
When will the Medicare trust funds run out? That depends on who you talk to. According to CMS, in... -
Six steps to ensuring a solid SNF billing system
Completing a Medicare claim correctly isn’t the only requirement to ensure accurate Medicare... -
Protecting electronic resident health information
The use of electronic health records (EHR) is a growing trend in long-term care today. Acute care... -
Resident-centered care in a data- and payment-driven industry
SNFs must provide quality care to residents in a field that is being suffocated by regulation and... -
Implications of consolidated billing under PDPM
Under CMS’ new payment model to be implemented October 1, 2019, the Patient-Driven Payment... -
Payer sources for senior living, nine ways
Senior living (also referred to as assisted living) is a cash-reliant industry, often paid for by...