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PDPM Top 10 Can’t Miss Success Strategies: Driving Quality Care & Reimbursement in 2021

by Proactive Medical Review | Feb 3, 2021 | blog, Documentation, MDS, Medical Review, Medicare, PDPM, Reimbursement

They say hindsight is 20/20. Most are glad to see 2020 go; it’s certainly been a challenging year. After the first full calendar year of the Patient-Driven Payment Model (PDPM), several key takeaways in terms of successful implementation strategies have become clear....

Nursing PDPM Documentation Suffering Due to COVID-19?

by Proactive Medical Review | Oct 19, 2020 | blog, Coding, Compliance, Documentation, MDS, Medical Review, Medicare, PDPM, Reimbursement

Has nursing documentation and internal auditing suffered due to COVID-19 prevention or outbreak efforts? Many facilities have had to prioritize staff and resources in order to meet the challenge of the public health emergency and the many additional responsibilities...

PDPM Coding & Documentation Top Risks: Tips from an Auditor (Part 2 of 2)

by Proactive Medical Review | Sep 23, 2020 | Audits, blog, Coding, MDS, Medical Review, Medicare, PDPM

As we began discussing in part 1 of this article last week, the accuracy of coding, documentation and data monitoring is vital as we prepare for the inevitable start of PDPM medical review audit activity.  Provider data outliers will trigger audits, and any coding...

Medicare Medical Review Activity Expected to Resume in August

by Proactive Medical Review | Jul 15, 2020 | blog, Medical Review, PDPM

CMS suspended most Medicare Fee-For-Service (FFS) medical review in late March due to the public health emergency (PHE). However, CMS has recently updated the COVID-19 Provider Burden Relief FAQ related to claim audit waivers. This update states that Medical Review...

COVID-19 Medical Review Preparedness and Reimbursement Compliance Risks

by Proactive Medical Review | May 19, 2020 | blog, CMS, Compliance, COVID-19, Medical Review, PDPM, Reimbursement

Throughout the COVID-19 pandemic, regulatory guidance, reimbursement waivers, and state requirements evolved quickly. Tracking these changes and implementing or updating facility processes to comply was a challenge on the best day. Add to the mix weeks of prolonged...

PDPM Medical Review Preparation: Tips for Assessing Data & Documentation

by Proactive Medical Review | Mar 10, 2020 | Coding, Documentation, Education, MDS, Medical Review, PDPM, SNF

Most facilities have fared better than anticipated under Patient-Driven Payment Model (PDPM). What will this mean from the standpoint of Medicare claims audits and how should we prepare for the inevitable start of medical review activity for PDPM claims?  For many...
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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