by Proactive LTC Consulting | Sep 13, 2021 | Blog, Compliance, COVID-19, Documentation, Medical Review, Medicare, SNF
On Sept. 8, 2021, CMS updated SE20011 (see p. 13) regarding Emergency SNF QHS and benefit period requirements under Section 1812(f) of the Social Security Act which were implemented to help restore SNF coverage for patients affected by the emergency. The update... by Proactive LTC Consulting | Aug 31, 2021 | Blog, Compliance, MDS, Medicare, PDPM, QAPI, Reimbursement
Strategies for timely estimation of potential care needs and costs are essential to SNF success, as well as systems for identifying clinical conditions and services that impact reimbursement under PDPM. Follow these steps to drive payment accuracy. Prior to Admission... by Proactive LTC Consulting | Aug 11, 2021 | Blog, Medicare, PDPM, Quality Measure, Regulatory, Reimbursement
July 29th, 2021, the Skilled Nursing Facility (SNF) prospective payment system (PPS) final rule was released. The rule, which goes into effect October 1, 2021, contained several updates, including factors affecting the usual payment rates, changes to diagnosis code... by Proactive LTC Consulting | Jul 14, 2021 | Medicare, Q&A
Q: We have a resident using Hospice Services for End Stage Renal Disease that fell and broke her hip. She had a 3-day hospital stay for ORIF. Prior to the fall, she was ambulatory. She is returning from the hospital with skilled therapy orders. Can we bill Medicare... by Proactive LTC Consulting | Jun 9, 2021 | Blog, Medicare, Regulatory, Reimbursement, Restorative, Therapy
Skilled maintenance therapy has long been a service offering available for use in long-term care, yet this programming continues to be the source of confusion for many providers. ”Maintenance Therapy”, is often requested by patients and their representatives/families... 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...