Mar 23, 2020
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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 06, 2020
 | 
The Bottom Line

The Centers for Medicare & Medicaid Services (CMS) has created a series of fact sheets explaining the basics of HIPAA Administrative Simplification transactions and code sets. These fact sheets are designed to help the healthcare industry understand the purpose of HIPAA adopted transactions (ncluding billing) and to explain which standards and operating rules govern each transaction

Feb 27, 2020
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The Bottom Line

Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) initial claims that are processed out of sequence are not paying the correct Variable Per Diem (VPD)-adjusted rate. Also, all adjustment claims are not processing correctly. Claims need to process in date of service order for each stay for the VPD to calculate correctly. CMS states it will correct this issue in October.

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