Note from the speaker: Valuable PDPM information for LTC finance professionals


By Maureen McCarthy, RN, BS RAC-MT, QCP-MT, DNS-MT, RAC-MTA

The Revenue Integrity Symposium (RIS) will bring opportunities for financial professionals to gain knowledge in their field by learning about what other experts have to say and what best practices may be beneficial for the Patient-Driven Payment Model (PDPM) transition. This year’s symposium will be held October 15–16 in Orlando.

There are a variety of PDPM sessions that will be beneficial to finance professionals in the long-term care (LTC) continuum.

I will be speaking on changes to the LTC billing process PDPM brings, such as a focus on weekly Medicare meetings, a triple-check focus, diagnosis code reviews, rejected claims, and gap billing.

Join me on Day 2 for my session “PDPM Crash Course for the Business Office.” This session will help billers understand what new information they should look for to ensure clinical documentation and claim documentation align, as well as reinforce traditional best practices to avoid denials and returns to providers. Also on Day 2, I will present “Reinventing Your Triple Check and Medicare Meeting Processes for PDPM Success.” The triple-check process verifies claims for accuracy and compliance with Medicare regulations before billing. Learn how to shift the discussion during your Medicare and triple-check meetings from rehab minutes to components under Section GG, return to provider codes, diagnosis coding specificity, and matching MDS documentation to the claim. This session will review ways to involve the entire interdisciplinary team to ensure maximum effectiveness.

Orlando is a special place for me, as it allows me to visit my parents who are local to the area. I also look forward to spending time with participants and helping LTC providers understand their future and get where they need to be!

I hope you’ll join me at RIS.

Editor’s Note: McCarthy is the president of Celtic Consulting, LLC, in Torrington, Connecticut, and the CEO and founder of Care Transitions, LLP, a post discharge care management service provider. She is also an AMBR Advisory Board member.

AMBR members get a $100 discount. Professionals wishing to earn support from program administrators to attend the 2019 Revenue Integrity Symposium may adapt our justification letter proposal.

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Tuesday, October 15, 2019 - 07:00

2019 Revenue Integrity Symposium

The 2019 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.