by Proactive LTC Consulting | Mar 21, 2023 | Blog, MDS, Medicare, PDPM, Reimbursement
Resident conditions and resource needs drive reimbursement under the Patient-Driven Payment Model (PDPM). Successful facilities have developed systems to effectively recognize and capture the differences among residents, particularly in the utilization of resources....
by Proactive LTC Consulting | Mar 7, 2023 | Blog, MDS, Medicare, PDPM, SNF
The Social Service department plays a significant role in daily nursing facility operations. From patient care planning, patient adjustment to facility admission, discharge planning, engaging with family/representatives, and beyond, social service staff members wear...
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 | Jun 21, 2022 | Coding, Medicare, Q&A
Q: Our Medicare Part A claim was rejected due to “principal diagnosis is an unacceptable diagnosis. Correct and resubmit/rekey”. The principal diagnosis coded on the Medicare claim and in section I0020B of the Medicare 5-day MDS is B95.62 (MRSA infection as the cause...
by Proactive LTC Consulting | May 4, 2022 | MDS, Medicare, Q&A
Q: A Medicare patient was admitted to our SNF in the morning and went home AMA later that same afternoon. What MDS assessments need to be completed? A: The Entry record and the unplanned discharge return not anticipated are required to be completed. In addition,...
by Proactive LTC Consulting | Mar 16, 2022 | CMS, Medicare, Q&A, SNF
Q: What should be done if a PPS 5-Day assessment completed for Managed Care is submitted to CMS? A: Assessments that are completed for purposes other than OBRA and SNF PPS reasons are not to be submitted, e.g., private insurance, including but not limited to...
