The new Patient Driven Payment Model (PDPM) goes into effect October 1st, 2019. While staff will continue to rely on computer software to convert MDS assessment data to calculate reimbursement rates, it will be vital to fully understand the rate calculation methodology to properly identify opportunities to maximize reimbursement and accurately project revenue. This two-day course will teach attendees how to effectively manage therapy utilization under PDPM; identify MDS changes and accurately complete item sets, with a focus on those that drive reimbursement; and demonstrate how to select the appropriate admitting ICD-10 codes and classification group for each resident.
This three-day intensive boot camp covers the latest Medicare rules and regulations so that you can help your facility provide quality resident care, document successfully, bill appropriately for services and prevent payment denials. This bootcamp follows a Medicare patient from preadmission through discharge, addressing the function of each department, and uncovering the pitfalls along the way.
Gain hands-on, how-to education focused on billing for Medicare Part A and B, the ins and outs of PDPM, consolidated billing, and accurately completing the UB-04. Plus, guidance on understanding the SNF coverage criteria and a breakdown of the different beneficiary notices.Learn about the latest Medicare billing rules and regulations so that you can help your facility bill appropriately for services and prevent payment denials.
AMBR is a professional organization dedicated to fostering the professional and educational growth of long-term care professionals through networking, continuing education, and analysis of complex regulations. AMBR helps its members successfully navigate the post-acute billing and regulatory environment by providing billing-specific education; a resource library of continuously updated tools, white papers, and webinars; networking opportunities; and in-depth reimbursement and regulatory guidance.
Building solid processes and systems is critical for staying compliant under the numerous CMS regulatory changes including PDPM and the new survey process. Membership grants your entire team year-round access to recognized experts, customized virtual education, and specially curated resources. Stay on top of industry changes that will impact your clinical and financial operations and gain strategies for achieving and sustaining compliance in the future marketplace.
With PDPM taking effect October 2019, SNFs must address how therapy services will change. This webinar will teach attendees how to properly prepare their facility and financially thrive under the new model. At the conclusion of this program, participants will be able to:
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:
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:
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.
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.
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.
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.