Most recent articles by Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Ask the payment expert … about IV fluids
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Jun 07, 2024
Our reimbursement specialist says we’ve missed several opportunities to code IV fluids given at the hospital on the 5-day PPS assessment. How is this information reported and supported?
Ask the payment expert… about the SNF 5-Claim Probe and Educate Reviews
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Apr 12, 2024
In an attempt to lower the skilled nursing facility improper payment rate, CMS implemented the SNF 5-Claim Probe and Educate Review, wherein the Medicare Administrative Contractors (MACs) conduct reviews...
Ask the payment expert … about incomplete measures
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Mar 04, 2024
I reviewed the Q4 2023 Facility Level Quality Measure report for my facility and noticed several measures are displayed as “I” for incomplete. Can you explain why?
Ask the paymenyt expert … about demand bills
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Feb 01, 2024
Under what circumstances are we required to submit a demand bill for a patient?
Ask the payment expert… about the Patient Health Questionnaire-9
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Dec 07, 2023
A:The Patient Health Questionnaire-9, or PHQ-2 to 9, is a widely used screening tool for depression, and in the context of nursing homes and PDPM it takes on even greater importance. This nine-question...
Ask the payment expert … about appealing Medicare repayments
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Nov 07, 2023
Q: My facility is going through a Medicare UPIC review and received several denials followed by a demand letter requiring repayment. What are options for appealing and paying?
Ask the payment expert … about payment reductions
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Oct 10, 2023
Q: How do I know what determines my 2% annual payment reduction? I’ve received a non-compliance letter citing MDS reporting requirements, but it doesn’t provide details.
Ask the payment expert … about MDS payment implications
By
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?
Ask the payment expert … about insufficient documentation
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Jul 07, 2023
Insufficient Documentation is the top SNF error leading to improper payment. What does this mean?
Ask the payment expert … about an LPN’s MDS role
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Jun 09, 2023
Q: We’ve been trying to fill an open MDS position and have an LPN applicant who would be great in the role. Can an LPN fulfill requirements and sign assessments?