Aug 29, 2019
The Bottom Line

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.

Read more and learn about AMBR discounts.

Aug 16, 2019
Billing Alert for Long-Term Care

Understaffing has become a major issue in SNFs. A study published in the July issue of Health Affairs, Daily Nursing Home Staffing Levels Highly Variable, Often Below CMS Expectations,” found that 75% of SNFs are rarely in compliance with staffing levels. According to the Institute of Medicine’s Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes, the number of RNs in a facility has been directly linked to that facility’s quality of care. When a facility is understaffed, it can be detrimental to the residents and cause headaches for administration—not to mention the possibility of fines and lower star ratings.

Aug 16, 2019
The Bottom Line

A class-action lawsuit filed by 14 SNF residents in 2011 challenging the Medicare three-day rule saw its first day in court on August 12. The lawsuit addresses the rule requiring residents to be admitted to an acute-care hospital for a minimum of three days prior to entering a SNF to receive Medicare coverage. The residents were unable to use their Medicare benefit because they had been under observation in the hospital, rather than admitted.

Jul 25, 2019
Billers' Association for Long-Term Care

CMS has announced July 17 two new rules that, according to a CMS press release, will place more focus on SNF residents as a priority over paperwork by reducing unnecessary regulations and protecting their legal interests. The proposed rule would delay Phase 3 requirements, including QAPI and ethics and compliance standards. The final rule upends the ban on SNFs offering arbitration agreements to residents. These changes, fueled by the Trump administration, will modify previous rules set forth between October 2016 and June 2017.

Jul 12, 2019
The Bottom Line

This book with downloadable tools helps you navigate recent changes to the RAI and includes more than 100 customizable care plan templates, as well as the most up-to-date care area assessment (CAA) worksheets from CMS. With many updated regulations already in effect, this timely book covers Section GG, discharge planning, QAPI, person-centered care, and survey changes, as well as the changes resulting from the ICD-10 transition.


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Featured Event

Tuesday, October 6, 2020 - 07:00

2019 Revenue Integrity Symposium

The 2020 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.

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