by PMR Team | Jul 9, 2019 | Audits, Compliance, Medicare, Regulatory, Reimbursement
The Quality Improvement Organization (QIO) Program originated with the Peer Review Improvement Act of 1982 and is authorized by Title XI Part B and Title XVIII the Act. The goal of the QIO program is to improve the quality of care for Medicare beneficiaries, including... by PMR Team | Jul 1, 2019 | Medicare, PDPM, Reimbursement, SNF, Therapy
Greater flexibility is good news for SNFs Beginning 10/1, up to 25% of therapy may be provided as group and/or concurrent treatment per discipline. Greater flexibility in how care and services may be delivered to Medicare patients is good news for SNFs, but keep in... by PMR Team | Jun 27, 2019 | Audits, Coding, Compliance, Medicare, PDPM, Regulatory, Reimbursement
A strong Triple Check process requires a group effort The Triple Check process is an internal audit that ensures billing accuracy and compliance with regulatory guidelines prior to the submission of claims to Medicare and other payors. A strong Triple Check process... by PMR Team | May 22, 2019 | MDS, Medicare, PDPM, Reimbursement, SNF
Highlights from the new RAI release Opportunity to Review Assessment Steps and Coding Guidance CMS has released the MDS 3.0 Resident Assessment Instrument (RAI) Manual v1.17 effective for assessments with an ARD of 10/1/2019 and after. PDPM guidance and calculation... by PMR Team | Apr 9, 2019 | Compliance, Medicare, Reimbursement, SNF
PEPPER: Program for Evaluating Payment Patterns Electronic Report Skilled Nursing Facility PEPPER Available The Q4FY18 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September... by PMR Team | Feb 7, 2019 | Compliance, Medicare, Therapy
CMS developed The National Correct Coding Initiative (NCCI) for Medicare Part B and Medicaid claims. NCCI is an automated edit system to control Current Procedural Terminology (CPT) code pairs that can be reported on the same day. The goal is to assure therapists are...