by Proactive LTC Consulting | Jan 6, 2020 | Audits, Compliance, Education, MDS, 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 PMR Team | Sep 25, 2019 | Audits, Compliance, MDS, PDPM, Reimbursement
Tips to focus your attention in October based on actual Proactive client pre-PDPM audit trends You’ve followed the PDPM transition checklists. You’ve analyzed historic billing patterns and projected revenue shifts under the new model. You’ve trained extensively.... by PMR Team | Aug 5, 2019 | Audits, MDS, PDPM, Reimbursement
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... by PMR Team | Jul 22, 2019 | Audits, Compliance, PDPM, Reimbursement
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... by PMR Team | Jul 9, 2019 | Audits, Compliance, Medicare, Regulatory, Reimbursement
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... by PMR Team | Jun 27, 2019 | Audits, Coding, Compliance, Medicare, PDPM, Regulatory, Reimbursement
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...