by Proactive Medical Review | Jul 7, 2021 | Abuse, blog, Compliance, Legal, Nursing, Regulatory
Even though SNFs have collectively seen higher reimbursement rates under the Patient-Driven Payment Model compared to the previous RUG IV payment model, data shows that there is still room for improvement for most facilities in terms of ensuring accurate revenue under...
by Proactive Medical Review | Jun 29, 2021 | Abuse, blog, Compliance, Legal, Nursing, Regulatory
When you became a long-term care Administrator or Director of Nursing you probably didn’t envision that you would also wear the hat of a detective. In today’s long-term care environment, being able to conduct a thorough internal investigation is a critical strength...
by Proactive Medical Review | Jun 17, 2021 | Audits, blog, Compliance, Medical Review, Regulatory, Reimbursement
The MACs officially resumed post-payment medical review of items and services with dates of service prior to March 2020 this past August, but according to a June 3, 2021 announcement may now officially begin conducting post-payment medical reviews for later dates of...
by Proactive Medical Review | Jun 15, 2021 | Audits, blog, Compliance, Medical Review, Regulatory, Reimbursement
The MACs officially resumed post-payment medical review of items and services with dates of service prior to March 2020, but may now officially begin conducting post-payment medical reviews for later dates of service. The Targeted Probe and Educate program will...
by Proactive Medical Review | Apr 21, 2021 | Audits, Compliance, Legal, Medicaid, Medical Review, Medicare
Following a year of little to no medical review and extensive government spending, most experts forecast reimbursement compliance audits ramping up in 2021. Multiple areas are ripe for potential scrutiny, including, but not limited to PDPM coding and supportive...
by Proactive Medical Review | Mar 31, 2021 | Antipsychotics/Psychotropics, blog, Compliance, Nursing, Quality Measure, Regulatory, SNF
Are you ready for the annual survey and the Unnecessary Medications, Psychotropic Medications, and Medication Regimen Review task that is part of that process? Surveyors select 5 residents to conduct this review on following the Critical Element Pathway. Consider...
