Each year, the OIG identifies healthcare programs that are vulnerable to fraud, waste, and abuse through erroneous claims. Using claim sampling techniques and audits, the OIG identifies billing vulnerabilities and
concerns specific to SNFs. Results of these vulnerabilities are published as reports or listings of common errors and should be analyzed to determine whether they are concerns for your facility.
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.