by Proactive LTC Consulting | Apr 16, 2025 | Coding, Compliance, Documentation, MDS, Medicaid, Medicare, Nursing
CMS has released the draft version of the MDS 3.0 RAI User’s Manual (v1.20.1), now available on the MDS 3.0 RAI Manual page. While the manual is still in draft form, the changes are significant and go into effect October 1, 2025. Facilities should begin planning now... by Proactive LTC Consulting | Apr 2, 2025 | Compliance, MDS, Medical Review, Medicare, PDPM, Reimbursement, Therapy
The State of SNF Medical Review in 2025: Trends, Challenges, and Key Findings Medical review of Skilled Nursing Facilities (SNFs) continues to be a focus of Medicare and Medicare Advantage oversight activities in 2025. With increased scrutiny from Medicare... by Proactive LTC Consulting | Feb 18, 2025 | Medicare, Reimbursement, SNF
Q: How does Consolidated Billing apply to dialysis services during a Skilled Nursing Facility (SNF) stay, and what is covered versus not covered? A: The consolidated billing requirement assigns the SNF the responsibility for billing the entire package of care... by Proactive LTC Consulting | Dec 30, 2024 | MDS, Medical Review, Medicare, SNF
Q: How can I ensure that claims are accurate prior to billing? A: The key to accurate claims submission is an effective Triple Check or Clean Claim review process. The Triple Check process is an interdisciplinary self-audit that aims to reduce the risk of... by Proactive LTC Consulting | Nov 13, 2024 | Compliance, Documentation, Medical Review, Medicare, Nursing, PDPM, SNF, Therapy
The Landscape of Skilled Service Justification in Skilled Nursing Facilities Compliance and accountability related to justifying skilled services is more important than ever. In Part 2 of this blog addressing justification of SNF Skilled Care, we’ll take a deeper look... by Proactive LTC Consulting | Nov 5, 2024 | Compliance, Documentation, MDS, Medical Review, Medicare, Nursing, PDPM, Quality, Regulatory, Reimbursement, SNF, Therapy
Skilled Service Justification in SNFs In the ever-evolving landscape of skilled nursing facilities (SNFs), the stakes have never been higher. With constant advancements in data analytics, regulatory bodies are sharpening their focus on compliance and accountability...