The state of New York is proposing a change in the way it calculates the case mix that sets Medicaid reimbursements for skilled nursing facilities — with the goal of realizing $246 million in net savings.
October 1 will be here before we know it. And with that comes Medicare’s new Patient-Driven Payment Model (PDPM) for beneficiaries accessing their skilled nursing facility (SNF) Part A benefit. It seems like every day there is a new webinar being advertised to help you understand the ins and outs of PDPM, but if there’s one thing you can know without any training, it’s that the new payment model is a much more complex system than the resource utilization group, version IV (RUG-IV) system that we operate under currently. As we analyze data collected in our facilities trying to understand our place in a PDPM world, though, don’t forget this important consideration: your therapy contract.
Join us June 12 for this 60-minute webinar in which attendees will learn the basics of the PDPM structure and how reimbursement will be calculated differently under a system driven by patient characteristics, rather than therapy minutes. PDPM’s effect on a facility’s revenue will also be explained, as well as MDS documentation’s new role in producing a clean claim, and how to ensure accurate reimbursement by including appropriate adjustment factors for certain components.
The Medicare Guide for SNF Billing and Reimbursement, Second Edition will help tackle the newest and most complex billing issues. This book will help billing staff understand the PDPM rate calculation methodology, identify opportunities to maximize reimbursement and accurately project revenue, correctly bill for Medicare Part A and Part B claims, and more!
This year, AMBR for Long-Term Care is partnering with the National Association for Healthcare Revenue Integrity (NAHRI) to offer a track at the Revenue Integrity Symposium dedicated to the unique billing and reimbursement challenges in that setting.
Performing a thorough preadmission screening on each resident will help ensure that the facility can afford to meet that individual’s care needs under PDPM. Use this preadmission screening flowsheetcreated by HCPro’s regulatory specialist and boot camp instructor, Stefanie Corbett, DHA, as a checklist to improve your process.
Join us October 15–16, 2019, at the Renaissance Sea World Orlando for the 2019 Revenue Integrity Symposium (RIS). Register now to take advantage of our early bird pricing ($100 off). AMBR members save an additional $100.