Find your copy of our exclusive AMBR Journal here. This quarter's issue contains in-depth features on:
MDS coordinators to take on quality
The onset of the PDPM marks another evolution for the MDS and MDS coordinators.
Experts uncover little-known risks and opportunities in PDPM
AMBR asked five long-term care experts to share key PDPM opportunities and risks that SNF providers may not have considered leading up to the transition.
Limit financial risk by enlisting billersto forecast profitability prior to admission
Determining and tracking the profitability of each potential new patient will be key to protecting the SNF’s bottom line in PDPM.
Consolidated billing made simple: Manage relationships
Proactively manage relationships with outside patients and external service providers to avoid costly consolidated billing mistakes
When it comes to knowing the difference between inclusions and exclusions in Consolidated Billing (CB), it can be extremely confusing for SNFs. Let’s first break it down by the basics. Included refers to items or services that are included in CB and for which the SNF must pay the outside vendor for specific services they provide. Excluded refers to items or services that are excluded from CB and may be billed by the outside vendor directly to Medicare Part B. Sometimes these items or services are also referred to as carve-outs.
The Revenue Integrity Symposium (RIS) brings together some of the industry’s leading experts to train on the most relevant, hot-button issues in long-term care (LTC). It also helps establish a sense of community between providers, fostering opportunities for networking and relationship-building. This year’s symposium will be held October 15–16 in Orlando.
Facilities are required to use modifiers for HCPCS code R0075 (transportation of portable X-rays). The Centers for Medicare & Medicaid Services (CMS) created the modifiers so that a facility can report the number of residents served during a single trip. You should use these codes only if the X-ray equipment was actually transported to the nursing home.
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.