by Proactive Medical Review | Jan 6, 2020 | Audits, Compliance, Education, Medical Review, PDPM
When reviewing the CMI components driving PDPM reimbursement it’s important to consider the critical role of the Non-Therapy Ancillary (NTA) score. The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. CMS...
by Amie Martin | Sep 7, 2018 | Compliance, Consulting, Medical Review, Testimonials
What Our Clients Say About Us PROACTIVE 5 STAR ACTION PLAN & SURVEY MANAGEMENT CONSULTING “Just wanted to let you know that we did very well with our DOH inspection — The survey team was also very complimentary of our Facility Assessment, they...
by PMR Team | Apr 9, 2018 | Compliance, Education, Medical Review
The Q4FY17 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2017 is now available for download through the PEPPER Resources Portal. To obtain your SNF’s PEPPER, the Chief...
by PMR Team | Mar 8, 2018 | Compliance, Medical Review
Health Inspection Changes On 11/24/2017, in S&C 18-04-NH, CMS announced upcoming changes to the Health Inspection domain of the Five-Star Quality Rating System. In this memo, CMS announced that they will hold constant the current health inspection star ratings on...
by PMR Team | Feb 14, 2018 | Medical Review, Medicare
Medicare Part B therapy caps have been permanently repealed as part of the bipartisan budget deal passed last week and signed by President Trump on Friday, 2/9/18. The repeal will be retroactive to January 1, 2018, but claims over $2010.00 (OT or PT/SLP combined) will...
by PMR Team | Nov 8, 2017 | Compliance, Medical Review, Therapy
This post has been modified or updated. Learn more about our services here or shop our tools and resources here. CMS has announced plans to expand the targeted probe approach to medical review to all MACs (Medicare Administrative Contractors.) TPE includes processes...
