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 15, 2021 | blog, Documentation, Legal, Medicaid, Medical Review, Medicare
“No matter how skilled or experienced you are, inaccurate or incomplete nursing documentation can mean serious trouble for your patients – and for you if you’re ever involved in a lawsuit.” Austin, Nursing2021. Many nurses who have had to testify in a deposition or...
by Proactive Medical Review | Jun 10, 2020 | blog, CMI, Education, Medicaid, Reimbursement
Case mix index (CMI) is the metric by which the relative cost of treating residents covered by Medicaid is measured. It also sheds light on the type of residents being treated and the burden of care required. Because the primary payer source for most facilities is...
by Proactive Medical Review | Apr 1, 2020 | blog, COVID-19, Education, Medicaid, Reimbursement
Q: What is an advance payment and how do I apply for one? A: An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims submission and/or claims processing. These expedited payments can be offered in...
