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
The new version of the MDS 3.0 RAI Manual, v1.17.1 are effective October 1, 2019 and incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas.
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.
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.
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!
The Patient-Driven Payment Model (PDPM) goes into effect October 1, 2019—just six months away. The new model bases reimbursement on the patient’s needs and acuity rather than the volume of services provided.