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... by Proactive LTC Consulting | Sep 23, 2020 | Blog, COVID-19, Reimbursement
CARES Act Provider Relief Fund The U.S. Department of Health and Human Services (HHS) Provider Relief Fund has made $50 billion available for distribution to Medicare fee-for-service providers as financial relief during the coronavirus (COVID-19) pandemic. Phases of... by Proactive LTC Consulting | Jun 10, 2020 | Blog, CMI, Education, Medicaid, Reimbursement
Case mix index (CMI) is the metric by which the relative cost of treating residents covered by Medicaid is measured. It also sheds light on the type of residents being treated and the burden of care required. Because the primary payer source for most facilities is... by Proactive LTC Consulting | Jun 3, 2020 | COVID-19, PDPM, Reimbursement, Telehealth
Q: I understand that CMS has approved telehealth services for outpatient therapy as billable on institutional claims (UB-04). Are we still restricted from utilizing telehealth therapy services for our Medicare Part A beneficiaries? A: The Centers for Medicare... 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... by Proactive LTC Consulting | May 13, 2020 | Blog, CMS, Coding, ICD.10, MDS, PDPM, Reimbursement
After 1000 PDPM coding audits completed since the PDPM transition, there are many trends our audit team has identified. This week’s blog highlights specific tips for selecting the primary diagnosis in Section I0020B based on common missed opportunities and errors...