SNF Patient-Driven Payment Model Bootcamp

Multiple Dates and Locations Available!

Association for Medicare Billing and Reimbursement for Long-Term Care (AMBR)

PROPELAdvisory Services

An Interdisciplinary Approach to ICD-19 Coding and PDPM Success

ON DEMAND

MDS expert Theresa Lang, RN, BSN, WCC, will help SNF attendees understand how to choose accurate primary diagnosis codes using the ICD-10 system so correct reimbursement can be achieved. Attendees will also learn how to avoid return-to-provider codes and how to make corrections if a claim is submitted with an invalid code.Topics covered include:

• Role of ICD-10-CM coding in PDPM
• Using diagnosis crosswalks to select the proper ICD-10 code
• Coding’s impact on reimbursement
• Facility process changes needed to succeed under PDPM

Improving Revenue Integrity Under PDPM

ON DEMAND

During this 60-minute webinar, Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, will explain the basics of the PDPM structure and how reimbursement will be calculated differently under a system driven by patient characteristics, rather than therapy minutes. Attendees will learn the effect PDPM will have on a facility’s revenue, MDS documentation’s new role in producing a clean claim, and how to ensure accurate reimbursement by including appropriate adjustment factors for certain components. At the program conclusion, participants will be able to:

• Identify six components of PDPM rates
• Understand those components with variable per diem adjustment factors
• Identify HIPPS code indicators that will be used under PDPM
• Recognize denial red flags and opportunities for correction on the claim
• Explain MDS documentation’s implications on the claim

MDS Care Plans: A Person-Centered, Interdisciplinary Approach to Care

Second Edition

Improve your CAA process and develop a more comprehensive plan of care while improving MDS 3.0 accuracy!

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. 

Medicare Guide for SNF Billing and Reimbursement

Second Edition

Long-term care billers play a vital role in ensuring proper reimbursement for their facility—but that role is not easy. With the new Prospective Payment System (PPS) transforming the long-term care billing landscape, billers need to ensure they are not leaving money on the table. This how-to manual will help tackle the newest and most complex billing issues and highlights the largest change in payment methodology since 1998. On October 1, 2019, the PDPM methodology will completely replace the previous RUG-IV system for reimbursement and rate calculations. Offering tables, charts, and tools outlining both case-mix and non-case-mix components that will form SNFs’ PPS rates, this book is the perfect referral resource to make sure you and your staff are filing clean claims under PDPM.

The Long-Term Care State Operations Manual

Updated March 2019!

Stay compliant with the most up-to-date regulations, interpretive guidelines, and newly assigned Ftags, and adhere to CMS’ guidance and survey requirements with The Long-Term Care State Operations Manual. Recently updated with Appendix Q, Core Guidelines for Determining Immediate Jeopardy.

Long-Term Care Quality Measures: A Guide to Data Analysis, Performance Improvement, and Public Reporting

This book gives readers a snapshot of the care delivered in a facility. This information affects facilities’ star ratings and gives customers a key source of information that reveals how well a facility is caring for its residents’ physical and clinical needs. However, getting a comprehensive picture of how QMs function can be time-consuming due to CMS’ extensive QM manual.

The guide provides a thorough drilldown of each QM. It supplies detailed explanations of each measure’s description, including numerator, denominator, and the facility’s and surveyor’s perspectives. This resource provides strategies for using your QM data to achieve performance improvement, insight into how CMS uses your QM data, and tips on using public reporting to track your quality improvement efforts.