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Need to brush up on the latest industry news? Look no further! Proactive Medical Review consultants provide up-to-date blog postings to keep you in the know.
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As part of the CMS Patients Over Paperwork Initiative, CMS is requesting comments on how to reduce administrative burden for providers. The purpose is to “increase quality of care, lower costs, improve program integrity, and make the health care system more effective,...read more
ICD.10 coding will have a major impact under PDPM ICD.10 coding will have a major impact under PDPM with the PT, OT, SLP and the bulk of the NTA items (35 of the 50 are diagnosis related items) paid in part based on the diagnoses coded on the MDS. You’ve attended...read more
Don’t miss the expert panel session on Operational Strategies for Success Under PDPM coming in August in our Moving Mountains Series! SNF experts in MDS coding, software, reimbursement, accounting, compliance and legal issues will share tips and strategies to conquer...read more
Missed coding will have a significant impact on the bottom line PDPM considers a vast array of patient characteristics in the reimbursement calculation. Primarily based on MDS coding accuracy to “paint the picture” of each resident’s needs, missed coding will have a...read more
The Quality Improvement Organization (QIO) Program originated with the Peer Review Improvement Act of 1982 and is authorized by Title XI Part B and Title XVIII the Act. The goal of the QIO program is to improve the quality of care for Medicare beneficiaries, including...read more
Greater flexibility is good news for SNFs Beginning 10/1, up to 25% of therapy may be provided as group and/or concurrent treatment per discipline. Greater flexibility in how care and services may be delivered to Medicare patients is good news for SNFs, but keep in...read more
A strong Triple Check process requires a group effort The Triple Check process is an internal audit that ensures billing accuracy and compliance with regulatory guidelines prior to the submission of claims to Medicare and other payors. A strong Triple Check process...read more
UPDATE: This blog has been updated 6/25/19. Please see below for details. Feedback from Indianapolis Summer Road Trip Attendee: “I started going to trainings last October for PDPM, but this was by far the best PDPM session I’ve ever attended!” PDPM Implementation...read more
Communicating PDPM essentials to Hospital Discharge Planners, the Medical Director, and Attending Physicians just got simpler.
Proactive has released two new PDPM toolkits: PDPM Physician Toolkit and Hospital PDPM Quick Guide and Hospital to SNF Discharge PDPM Documentation Checklist PDPM Physician Toolkit ($129) The PDPM Physician Toolkit provides the essential information and query process...read more
Effective systems critical for a robust Compliance Program A compliance program is made up of the written policies, procedures and day to day operational actions that focus on preventing and detecting violations of law and regulations and on promoting care quality....read more
*This blog was updated 7/9/19. To register for an upcoming "Moving Mountains" webinar in your area, visit your organization’s website for details. Click here to find your association. More Moving Mountains Webinar Details Added! We've partnered with industry...read more
The Path to 5 Star Quality Measures: Percent of residents whose need for help with activities of daily living has increased
This blog is one in a series of blogs focusing on SNF 5-Star Quality Measures. Click here to see all 5 star blogs. CMS Five-Star Quality Rating System: The Path to 5-Star QMs Percent of residents whose need for help with activities of daily living has increased One of...read more
PDPM includes specific provisions to ensure that it accounts for the increased costs associated with caring for SNF patients with HIV/AIDS. Is your facility prepared to manage complex care plans associated with higher acuity admissions? Historically in accordance with...read more
Highlights from the new RAI release Opportunity to Review Assessment Steps and Coding Guidance CMS has released the MDS 3.0 Resident Assessment Instrument (RAI) Manual v1.17 effective for assessments with an ARD of 10/1/2019 and after. PDPM guidance and calculation...read more
It may be time to assess your facility Restorative Nursing Program as part of your PDPM transition preparedness plan. Restorative Basics The fundamental requirements for Restorative nursing will remain the same under PDPM. Per the RAI manual, Restorative Nursing...read more
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