Apr 03, 2020
 | 
Billing Alert for Long-Term Care

CMS is delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for October 1, 2020, in response to stakeholder concerns. The MDS item sets are used by Nursing Home and Swing Bed providers to collect and submit patient data to CMS. This MDS data informs payment, quality, and the survey process.

Mar 27, 2020
 | 
Billing Alert for Long-Term Care

On March 10, the Centers for Medicare & Medicaid Services (CMS) took further action to ensure patients have access to the critical healthcare services they need in the wake of the 2019 Novel Coronavirus (COVID-19) outbreak. Following a meeting with President Trump and Vice President Pence, many leading insurance companies and their industry associations announced they will be treating COVID-19 diagnostic tests as covered benefits and will be waiving cost sharing that would otherwise apply to the test. The President also directed CMS to provide more flexibility to Medicare Advantage and Part D plans to ensure they have the tools they need to provide seniors with the best coverage. As a result, CMS published a memorandum to Medicare Advantage (MA) and Part D health and prescription drug plans informing them of the flexibilities they have to provide healthcare coverage to Medicare beneficiaries for COVID-19 testing, treatments, and prevention.

Mar 23, 2020
 | 
The Bottom Line

CMS is delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for October 1, 2020, in response to stakeholder concerns. The MDS item sets are used by Nursing Home and Swing Bed providers to collect and submit patient data to CMS. This MDS data informs payment, quality, and the survey process.

Mar 20, 2020
 | 
The Bottom Line

In order to address provider’s concerns regarding COVID-19, we have created a coronavirus forum where providers can connect with one another. The forum can include topics such as supplies, visitation, concerns, regulations, mandates, infection control, payment, staffing, etc. You’re not alone in this, we have you covered. Visit the forum to post questions, concerns, and tips and receive input from other providers across the nation. Join here.

Mar 20, 2020
 | 
Billing Alert for Long-Term Care

There is no requirement that a coder in SNFs be certified. It would be ideal to have certified coders in the SNF, but this is not a realistic expectation. Those responsible for coding need medical terminology, anatomy, and pathophysiology knowledge. This can be a medical records professional (associate degree), bachelor’s degree, or master’s degree educational preparation. A degree does not ensure that the person has a coding certification. Many health unit coordinator programs include diagnosis in the course curriculum. Frequently, nurses have chosen to work in the health information management field. Nurses make good coders due to their educational background but need to be careful not to read into a provider’s documentation or assume relationships between documentation entries.

Mar 06, 2020
 | 
The Bottom Line

CMS has developed a second Healthcare Common Procedure Coding System (HCPCS) code that can be used by laboratories to bill for certain COVID-19 diagnostic tests to help increase testing and track new cases. In addition, CMS released new fact sheets that explain Medicare, Medicaid, Children’s Health Insurance Program, and Individual and Small Group Market Private Insurance coverage for services to help patients prepare as well. For further COVID payment guidance, view CMS' fact sheet.

Pages

Quarterly Member Calls

Members-only calls

Enjoy upcoming and past Quarterly Calls with your AMBR Membership! Click here!

Access sample white papers, tools, analysis, and resources.

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.

AMBR Forums

To participate in the AMBR forum discussions, you must be a member of the AMBR community. Please subscribe today or login for access.

tsadoyama
jku369@comcast.net
jku369@comcast.net
jku369@comcast.net