by Proactive Medical Review | Mar 17, 2020 | Education, Medical Review, PDPM, SNF
With the growing concern surrounding Coronavirus (COVID-19) and the slew of emails you’re likely receiving, we want to provide you with a brief, focused summary of how this pandemic has temporarily changed our current practices and regulations surrounding our Medicare...
by Proactive Medical Review | Mar 10, 2020 | Education, 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...
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...
