by Proactive LTC Consulting | Mar 10, 2020 | Coding, Documentation, Education, MDS, Medical Review, PDPM, SNF
Most facilities have fared better than anticipated under Patient-Driven Payment Model (PDPM). What will this mean from the standpoint of Medicare claims audits and how should we prepare for the inevitable start of medical review activity for PDPM claims? For many... by Proactive LTC Consulting | Feb 4, 2020 | Medicare, PDPM, Q&A, SNF
Q: If a resident is cut from skilled services but a new skilled need arises during the interrupted stay window, would the facility be allowed to re-skill the resident? A: The Medicare Benefit Policy Manual, Chapter 8 states that “Another qualifying hospital... by Proactive LTC Consulting | Feb 4, 2020 | Medicare, PDPM, Q&A, SNF
Q: What would happen if the interrupted stay criteria was met, but the resident came back from the hospital with a new diagnosis? A: In order to utilize Medicare benefits, even if the criteria of the Interrupted Stay Policy have been met, the resident must... by Proactive LTC Consulting | Jan 14, 2020 | Blog, Medicare, PDPM, SNF
With focus primarily on successful implementation of the Patient Driven Payment Model (PDPM) in recent months, now is a good time to revisit the importance of a solid process for the Medicare Meeting, or Utilization Review Meeting. Under PDPM, some providers have... by Proactive LTC Consulting | Jan 6, 2020 | MDS, PDPM, SNF
The Centers for Medicare & Medicaid Services (CMS) announced that a new DRAFT version of the 2020 MDS item sets (v1.18.0) has been posted. The most impactful change was removing Section G from all Federal item sets. This will help eliminate the coding... by Proactive LTC Consulting | Dec 31, 2019 | Medicare, PDPM, Q&A, SNF
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: If a resident discharges and returns from an interrupted stay do we start over on the Medicare certification? A: If the resident qualifies for the interrupted...