Ask the payment expert … about MDS payment implications
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Sep 12, 2023
Q: Are changes to the Patient Driven Payment Model expected with the revised MDS in October?
CMS 5-claim audits so far a ‘debacle’
Jessica R. Towhey
Aug 22, 2023
A new federal review process designed to lower the rate of improper government payments is sending provider staffs scurrying to justify their coding.
Ready, set, review!
May 11, 2023
We’ve all been waiting for this. We knew it was coming! What am I speaking of? The May 4, 2023, notice of Skilled Nursing Facility (SNF) 5-Claim Probe and Educate Review, of course! Since the initiation...
CMS eyeing PDPM case-mix additions, changes
Apr 24, 2023
Federal regulators are weighing changes to the three-year-old Patient Driven Payment Model to account for missed opportunities — and potentially inappropriate coding choices — a top Medicare official...
Pay good providers more to care for dementia patients, researchers urge
Feb 09, 2023
Policymakers should consider incentivizing nursing homes to take patients with Alzheimer’s disease and related dementias, argue the authors of a new study that finds such patients currently are more...
Medicare Advantage plans forcing providers to take ‘optional’ payment reductions
Nov 15, 2022
Many skilled nursing providers are still underusing Interim Payment Assessments under the nascent Patient Drive Payment Model, but one new pressure is driving some to submit those extra patient evaluations...
Providers ‘on notice’ as CMS pressures states to shift Medicaid pay metrics
Nov 10, 2022
Providers still struggling to accurately capture diagnoses that drive federal reimbursement will be doubly left behind as more states start to use Patient Driven Payment Model-like systems to determine...
Need a PDPM boost? A new study points to physiatrists for $34,000 monthly kick
Oct 20, 2022
Physiatrists can help skilled nursing facilities more accurately capture reimbursement under the Patient Driven Payment Model, a leading payment consultant said Tuesday.
MDS meets VBP: I love a good value, don’t you?
Oct 10, 2022
I love a good value, don’t you? It’s hard to find one these days in this economy. Recently a friend of mine purchased a used vehicle from a reputable local dealership. Within a week, the engine...
Final pay rule and rates: A primer for rehab professionals
Sep 01, 2022
The October 2019 industry shift to the Patient Driven Payment Model allowed all rehabilitation professionals the opportunity to document specific clinical characteristics about the patients we serve and...