by Proactive LTC Consulting | Feb 22, 2023 | Blog, F-Tag, Medicaid, Medicare, Regulatory, Reimbursement
Medicare beneficiaries in a SNF have rights and safeguards with regard to financial liability and appeal of the denial of Medicare services. Providers are required to inform beneficiaries of their financial liability and their appeal rights in writing by issuing...
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 | Mar 15, 2021 | Blog, Documentation, Legal, Medicaid, Medical Review, Medicare
“No matter how skilled or experienced you are, inaccurate or incomplete nursing documentation can mean serious trouble for your patients – and for you if you’re ever involved in a lawsuit.” Austin, Nursing2021. Many nurses who have had to testify in a deposition or...
by Proactive LTC Consulting | Jun 10, 2020 | Blog, CMI, Education, Medicaid, Reimbursement
Case mix index (CMI) is the metric by which the relative cost of treating residents covered by Medicaid is measured. It also sheds light on the type of residents being treated and the burden of care required. Because the primary payer source for most facilities is...
by Proactive LTC Consulting | Apr 1, 2020 | Blog, COVID-19, Education, Medicaid, Reimbursement
Q: What is an advance payment and how do I apply for one? A: An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims submission and/or claims processing. These expedited payments can be offered in...
by PMR Team | Mar 1, 2018 | MDS, Medicaid
The Ohio Department of Medicaid (ODM) has awarded Myers and Stauffer with the contract to conduct exception reviews. “Exception review” is a review of minimum data set (MDS) assessment data. The purpose of an exception review is to identify any patterns or...
