News / Blog
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.
The latest news, events, blogs and more…
PDPM Coding & Documentation Worries?
PDPM Coding Support Solutions For Compliance and Reimbursement Accuracy Proactive provides the MDS coding support and pre-submission audits you need to capture what scrubbers miss. On average, our clients experience a 90% return on their audit investment. How can we...
Therapy Vendor Contracts Under PDPM
Providers will benefit from moving beyond a billable minute or RUGs based therapy contract under PDPM Therapy contracts are under review for many providers. In most cases, providers will benefit from moving beyond a billable minute or RUGs based therapy contract under...
Key Steps to 5 Star Rating: Mock Survey
Poor survey outcomes have serious and long-lasting negative effects Skilled Nursing Facilities (SNFs) are highly regulated and are in the midst of many changes impacting survey success. Ensuring facility compliance prior to the annual recertification survey or...
EVENT: PDPM Implementation Intensive Summer Road Trip
UPDATE: This blog has been updated 8/16/19. Please see below for details. Feedback from Summer Road Trip Attendees: “I started going to trainings last October for PDPM, but this was by far the best PDPM session I’ve ever attended!” "Relevant content & interesting...
Auditing & Monitoring Updates Essential under PDPM
PDPM should be included in the Compliance and Ethics program work plan Challenges during the transition to PDPM (Patient Driven Payment Model) are unavoidable, but compliance oversight doesn’t need to be one of them. PDPM should be included in the Compliance and...
Expert Panel Session on Operational Strategies for Success Under PDPM
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...
CMS Requests Provider Input to Reduce Administrative Burden
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,...
PDPM Ready! ICD.10 Codes and RTP Status
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...
Planning Ahead for PDPM Success
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...
QIO Contract Updates
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...
Understanding PDPM Group Therapy Changes and FREE Group Therapy Tip Sheet
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...
Is Your Triple Check PDPM Ready?
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...
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...
Phase 3 SNF Compliance and Ethics Program Essentials: Reporting Processes
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....
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...