Reimbursement under PDPM

Reimbursement under PDPM will require updates to clinical systems, policies and procedures, and operational focus.

MDS coding accuracy is paramount to appropriate payment, and coding accuracy requires consistent interdisciplinary team communication, data quality, efficiency to capture information for the five day assessment, and understanding of the critical elements and “moving parts” of the new model. Proactive created a facility PDPM action plan as part of the Moving Mountains webinar series which many facilities are using to guide a successful transition. At this point in your facility transition, the following tasks should be complete:

  • RUG IV to PDPM impact analysis
  • Clinical Category Mapping review and coding audits
  • PDPM overview training
  • Establish transition team
  • Facility specific action plan with timelines and responsibilities assigned

Need a hand getting up to speed? Proactive offers a partnership plan to guide your successful transition. Our training, tools, and clinical reimbursement experts will ensure you are prepared for the October 1st transition to PDPM. Contact us for more information on our budget friendly flat-rate partnerships billed in easy installment payments.

Click here to download the PDPM Action Plan now.

View our PDPM Moving Mountains on Demand Training

The Proactive clinical education team includes experienced therapist, nurse, MDS, Compliance Officer, and health facility administrator experts with backgrounds in multi-facility operations, contract therapy services, survey management, EMR systems, healthcare compliance, corporate training, clinical program development, QAPI, and litigation support. Learn more about PDPM Moving Mountains here.

Restorative Nursing Competency Toolkit

Check out Proactive’s Restorative Nursing Competency Toolkit—just one of the many grab-and-go resources available for easy competency-based staff development programs. Click here to learn about this toolkit.

Get more resources in our shop!

Patients rely on you. You can rely on us. Find toolkits, webinars, on-demand trainings, templates, and much more to meet the needs of your facility. Click here to visit our shop.

Blog by Amie Martin, President, Proactive Medical Review

Click here to learn more about Amie and the rest of the Proactive team.