by Proactive LTC Consulting | Apr 21, 2021 | Audits, Compliance, Legal, Medicaid, Medical Review, Medicare
Following a year of little to no medical review and extensive government spending, most experts forecast reimbursement compliance audits ramping up in 2021. Multiple areas are ripe for potential scrutiny, including, but not limited to PDPM coding and supportive... by Proactive LTC Consulting | 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... by Proactive LTC Consulting | May 21, 2020 | Audits, Blog, Coding, COVID-19, Education, ICD.10, MDS
Q: What is the #1 ICD.10 coding error that you find in your audits? A: Answer: The coding error seen most often is using acute conditions/diagnoses. The RAI Manual states while certain conditions represent acute diagnoses, SNFs should not use acute diagnosis... 
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...