Nursing home operators need to make sure their MDS coordinators are paying close attention to the changes to the prospective payment system, an expert said yesterday during the last 2011 McKnight’s Super Tuesday webinar.
Coordination between MDS and billing databases needs to be seamless in order for the Centers for Medicare & Medicaid Services to process claims, according to Leah Klusch, RN, BSN, in “Keeping pace with the MDS 3.0.” Klusch is an expert in the areas of coding and payment, and is the executive director of the Alliance Training Center.
“The first thing you need to do is make sure you have proper respect and operational influence and support for the MDS process. Never have we seen PPS changes like this that involve manualized changes in definitions and procedure,” Klusch said. Upcoming changes, which start Oct. 1, include how therapy is billed, with one example being new coding for end-of-therapy resumption.
“Inaccurate data or non-compliant processes can be viewed by CMS as fraud. There is very little forgiveness anymore,” she said. Klusch also advised operators to budget for training. With less than four weeks left before the new rules and procedures to kick in, administrators cannot afford to be unprepared.
“Assessments and billing data must be congenial or payment can be denied or delayed,” Klusch added.