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SNF PEPPER Available: Do you have outliers that may trigger medical review?

by Proactive Medical Review | Apr 6, 2022 | blog, Compliance, SNF

The Q4FY21 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2021 is now available for download. Follow these steps to access your PEPPER and analyze any outlier billing...

If I Were Your Compliance Officer

by Proactive Medical Review | Mar 30, 2022 | blog, Compliance, MDS, Reimbursement

Our office regularly receives urgent calls from providers in crisis.  We are in the business of coming alongside nursing facilities to shoulder a portion of the burden, drive corrective actions and assist to remedy problem situations. Given the choice and resources,...

MDS 3.0 Refresh: Mastering the Art of Coding Accuracy

by Proactive Medical Review | Mar 23, 2022 | blog, Compliance, MDS, Reimbursement

Compliance, Accuracy, Quality. These are words we’ve heard over and over in long-term care. They are part of our everyday regulatory landscape and are essential to MDS data integrity. Despite two years under our belts operating under the PDPM payment model, data shows...

F689 Accident Hazards/Supervision/Devices

by Proactive Medical Review | Sep 13, 2021 | 5 Star, blog, Compliance, Falls, Nursing, QAPI, Quality, Regulatory, SNF, Survey

F689 Free of Accident Hazards/Supervision/Devices has been the third most frequently cited F tag so far in the 2021 fiscal year per Casper data (9/5/21).  3,466 citations have been issued nationally for the  16.6% of providers surveyed. Scope and Severity has ranged...

SNF Waiver Clarification Issued & Medical Review Anticipated

by Proactive Medical Review | Sep 13, 2021 | blog, Compliance, COVID-19, Documentation, Medical Review, Medicare, SNF

On Sept. 8, 2021, CMS updated SE20011 (see p. 13)  regarding Emergency SNF QHS and benefit period requirements under Section 1812(f) of the Social Security Act which were implemented to help restore SNF coverage for patients affected by the emergency. The update...

Predicting PDPM Reimbursement

by Proactive Medical Review | Aug 31, 2021 | blog, Compliance, MDS, Medicare, PDPM, QAPI, Reimbursement

Strategies for timely estimation of potential care needs and costs are essential to SNF success, as well as systems for identifying clinical conditions and services that impact reimbursement under PDPM. Follow these steps to drive payment accuracy. Prior to Admission...
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Proactive Medical Review Consulting, LLC

2207 Morgan Ave, Suite D
Evansville, IN 47711

Phone: (812) 471-7777
Fax: (812) 471-7802
info@proactivemedicalreview.com