Vol. 21, Issue 4, April 26, 2019
Apr 25, 2019
Billing Alert for Long-Term Care

Q. Should therapy treatment practices change under the Patient-Driven Payment Model (PDPM)?

A. Even though therapy minutes are no longer relevant to the provision and payment for therapy, CMS has assumed that most therapy will continue to be provided one-on-one. SNFs with contract providers need to take great care to ensure that the contractor does not automatically ramp up inpatient therapy on a group and concurrent basis to the 25% threshold!

Unless the facility has experienced a significant change in overall case mix from when under resource utilization groups (RUG) to PDPM (fewer therapy-qualified residents), there would be no logical clinical reason to change treatment practices.

Apr 05, 2019
Billing Alert for Long-Term Care

by Deborah Collum, national director of revenue cycle management at Covenant Retirement Communities and AMBR Advisory Board member

Implementing a revenue cycle management (RCM) model in your facility will help you streamline your billing process to prepare for the Patient-Driven Payment Model (PDPM) to be implemented October 1, 2019. If your billing office still follows an accounts receivable (AR) model that only focuses on outstanding accounts, you’re not alone—but it may be time for a change.

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