Billing

Expert says providers often wrongly threatened by PEPPER reports

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Instead of fearing further scrutiny by federal authorities, providers should embrace the opportunity to get feedback in the form of PEPPER reports, legal experts said Monday at the LeadingAge annual meeting in Nashville.

Froyo funding for long-term care

Froyo funding for long-term care

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I have been blessed with an astute business mind, and am always on the lookout for new pricing models for long-term care. I know we're in this profession for love, not money. But no margin, no mission, as they say. Which is much better than what they used to say — no profit, no point.

Long-term care and therapy: It's complicated

Long-term care and therapy: It's complicated

There is an option in Facebook to mark your relationship status as, "It's complicated." This is a great way to sum up everything, without getting too personal. Even though posting your relationship status on Facebook is personal. It's also great way to characterize long-term care therapy.

Skilled nursing facility trends contribute to improved Medicare outlook, Congressional report says

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The Medicare trust fund is on track to remain solvent until 2030, trustees of the program stated in a Congressional report released Monday. This improved outlook is due in part to revised expectations about the case mix in skilled nursing facilities.

Diagnotes Inc. and Advanced Healthcare Associates team up

Diagnotes Inc. and Advanced Healthcare Associates have announced an expanded partnership that will place the Diagnotes mobile and web-based clinical communication system.

Diagnosing cash flow problems in a SNF

Diagnosing cash flow problems in a SNF

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Nursing homes operate in a difficult environment where they face constant financial pressures. On the revenues side are payers who are always trying to negotiate lower prices and slower payments. On the expenses side are high debt payments coupled with supplier who want to raise prices, and so on.

Interoperability in senior living: Making it a reality

Interoperability in senior living: Making it a reality

Don't expect one company to complete all of your needs. Before you select your favorite clinical system, talk with suppliers about what accounting systems are already integrated and how these systems can reduce cost and risk

Top 5 ICD-10 changes for 2014

Top 5 ICD-10 changes for 2014

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Have you started your countdown clocks yet? It looks like it's definitely happening this year on Oct. 1, 2014. The transitions from ICD-9 to ICD-10 coding will 100% absolutely take effect for the entire healthcare system, including therapy. So what is this big change all about? Per CMS, here are a couple of key facts everyone should be preparing for.

Billing system overhauled at Optimus EMR

Optimus EMR Inc. announced the launch of its new Optimus Billing and Financial System (OBFS) last week. The OBFS is fully integrated with the company's EMR clinical system, sharing one point of entry and a common database with the clinical EMR system.

NPs face pay challenges in some states

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While the number of nurse practitioners is expected to nearly double by 2025, many in the field say payer policies hurt their efficiency, even more than state scope-of-practice laws.

Ahhhhhhhh, there's the rub

Ahhhhhhhh, there's the rub

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In all the tumult over the Time magazine expose of pervasive and obscene healthcare billing excesses, you might have missed the almost as exciting discovery that foot massages at work lower blood pressure and anxiety for dementia caregivers. At least one snippy McKnight's reader irately claims this isn't "real news." He or she definitely needs a lengthy foot rub, and possibly half a Xanax dissolved in a cup of chamomile tea.

Proper evaluation documentation that supports nursing home billing the focus of webcast for clinicians

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In light of recent allegations of gross upcoding in therapy circles, an upcoming webcast on appropriate patient evaluation and management documentation could prove popular. Alva Baker, M.D., CMD, who has been a medical director for 29 years, will examine the relationships between E/M documentation and coding and billing. Topics within the webcast include a review of the billing codes for services provided to residents in the long-term care setting, as well as the E/M documentation system. The event will take place from 7 p.m. to 8:30 p.m. (Eastern Time) on Thursday. It is sponsored by the American Medical Directors Association.

When LTC leaders delegate accountability

When LTC leaders delegate accountability

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What happens when delegation without accountability takes place? We saw a good example last week, when the Office of Inspector General released a damning report about excessive Medicare charges from nursing homes.

Providers should prepare to face even more audits under healthcare reform, expert warns

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Providers need to have the appropriate staff and data analytics programs in place to defend against the onslaught of more Medicare and Medicaid claims audits, an expert urged.

Why are more RAC audits happening? There are trillions of reasons

Why are more RAC audits happening? There are trillions of reasons

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Recovery audit contractors are stepping up their efforts to review Medicare billings. This appears to be a classic case of auditors gone wild.

CMS to host national conference call focusing on assessments, billing and other top long-term care issues

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The next federal "Open Door Forum" for skilled nursing and long-term care operators takes place at 1 p.m. Thursday. Regulators say they hope to address MDS 3.0, billing, website and ENCORE issues. The monthly hour-long calls are hosted by the Centers for Medicare & Medicaid Services and are open to all interested stakeholders. Those who want to listen in or ask a question should dial (800) 837-1935 and give reference number 27269788. Officials recommend calling in about 15 minutes early in order to ensure hearing the start of the session.

Point-of-service: Friend or foe?

Point-of-service: Friend or foe?

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As a manager, I used to love to promote point-of-service, or POS. As a therapist, I used to despise POS. How could I have such a love-hate relationship with POS?

Point-of-service: Friend or foe?

Point-of-service: Friend or foe?

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As a manager, I used to love to promote point-of-service, or POS. As a therapist, I used to despise POS. How could I have such a love-hate relationship with POS?

When bad policies get due notice

When bad policies get due notice

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You can thank some boneheaded long-term care executives from across the pond for the latest black eye to your profession.

CMS clarifies provider termination criteria

CMS clarifies provider termination criteria

The Centers for Medicare & Medicaid Services has clarified the terms under which states can terminate a provider's participation in state Medicaid programs.

CMS newsletter addresses Medicare billing, compliance issues facing providers

CMS newsletter addresses Medicare billing, compliance issues facing providers

The Centers for Medicare & Medicaid Services on Tuesday released the first edition of a new quarterly newsletter that aims to help providers avoid Medicare billing and compliance errors.

Report: Nursing home therapy reimbursement under review as reform law toughens up

Report: Nursing home therapy reimbursement under review as reform law toughens up

Healthcare analysts at the Department of Health and Human Services are re-evaluating Medicare's "ultra-high" billing category for therapy services in skilled nursing facilities as a potential way to reduce wasteful spending, according to a Washington Post report.

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