by PMR Team | Jul 15, 2019 | Compliance, Medicare, PDPM, Reimbursement
ICD.10 coding will have a major impact under PDPM ICD.10 coding will have a major impact under PDPM with the PT, OT, SLP and the bulk of the NTA items (35 of the 50 are diagnosis related items) paid in part based on the diagnoses coded on the MDS. You’ve attended...
by PMR Team | Jul 10, 2019 | Compliance, Medicare, PDPM, Reimbursement
Missed coding will have a significant impact on the bottom line PDPM considers a vast array of patient characteristics in the reimbursement calculation. Primarily based on MDS coding accuracy to “paint the picture” of each resident’s needs, missed coding will have a...
by PMR Team | Jul 9, 2019 | Audits, Compliance, Medicare, Regulatory, Reimbursement
The Quality Improvement Organization (QIO) Program originated with the Peer Review Improvement Act of 1982 and is authorized by Title XI Part B and Title XVIII the Act. The goal of the QIO program is to improve the quality of care for Medicare beneficiaries, including...
by PMR Team | Jun 27, 2019 | Audits, Compliance, PDPM, Regulatory, Reimbursement
A strong Triple Check process requires a group effort The Triple Check process is an internal audit that ensures billing accuracy and compliance with regulatory guidelines prior to the submission of claims to Medicare and other payors. A strong Triple Check process...
by PMR Team | Jun 12, 2019 | Compliance, Consulting, SNF
Effective systems critical for a robust Compliance Program A compliance program is made up of the written policies, procedures and day to day operational actions that focus on preventing and detecting violations of law and regulations and on promoting care quality....
by PMR Team | May 14, 2019 | Compliance, Regulatory, SNF, Training
Protect your facility and residents from adverse events and negative survey outcomes. The Phase 3 SNF §483.95 Training Requirements must be in place by November 28, 2019. As part of the new requirements, nursing facilities will be required to develop, implement, and...
