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Nursing PDPM Documentation Suffering Due to COVID-19?

by Proactive LTC Consulting | Oct 19, 2020 | Blog, Coding, Compliance, Documentation, MDS, Medical Review, Medicare, PDPM, Reimbursement

Has nursing documentation and internal auditing suffered due to COVID-19 prevention or outbreak efforts? Many facilities have had to prioritize staff and resources in order to meet the challenge of the public health emergency and the many additional responsibilities...

PDPM Coding & Documentation Top Risks: Tips from an Auditor (Part 2 of 2)

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...

Medicare Medical Review Activity Expected to Resume in August

by Proactive LTC Consulting | Jul 15, 2020 | Blog, Medical Review, PDPM

CMS suspended most Medicare Fee-For-Service (FFS) medical review in late March due to the public health emergency (PHE). However, CMS has recently updated the COVID-19 Provider Burden Relief FAQ related to claim audit waivers. This update states that Medical Review...

COVID-19 Medical Review Preparedness and Reimbursement Compliance Risks

by Proactive LTC Consulting | May 19, 2020 | Blog, CMS, Compliance, COVID-19, Medical Review, PDPM, Reimbursement

Throughout the COVID-19 pandemic, regulatory guidance, reimbursement waivers, and state requirements evolved quickly. Tracking these changes and implementing or updating facility processes to comply was a challenge on the best day. Add to the mix weeks of prolonged...

PDPM Medical Review Preparation: Tips for Assessing Data & Documentation

by Proactive LTC Consulting | Mar 10, 2020 | Coding, Documentation, Education, MDS, Medical Review, PDPM, SNF

Most facilities have fared better than anticipated under Patient-Driven Payment Model (PDPM). What will this mean from the standpoint of Medicare claims audits and how should we prepare for the inevitable start of medical review activity for PDPM claims?  For many...
Reducing Missed Non-Therapy Ancillary (NTA) Opportunities

Reducing Missed Non-Therapy Ancillary (NTA) Opportunities

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...
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Proactive LTC Consulting

2207 Morgan Ave, Suite D
Evansville, IN 47711

Phone: (812) 471-7777
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info@proactiveltcexperts.com