Why would anyone mention value-based reimbursement, medical necessity and the Jimmo lawsuit in the same sentence? I feel they are all related, but it will be difficult to find the perfect balancing act...
The G-codes are here for payment claims — ready or not
By
Shelly Mesure, MS, OTR/L
May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers...
Rehab Week 2017: Where’s the skill?
By
Renee Kinder
Sep 28, 2017
Therapists across the nation had reason to celebrate their varied and respected skills last week. It was National Rehab Awareness Week after all. My, how the celebrations went down.
OIG? OMG! One lump problem
By
Shelly Mesure, MS, OTR/L
Jan 23, 2013
The Office of the Inspector General’s recent report about what it calls $1.5 billion in inappropriate Medicare payments to skilled nursing facilities should be yet another wake-up call to providers.
What’s on Your PEPPER Report?
By
Shelly Mesure, MS, OTR/L
Sep 10, 2013
Have you received your provider-specific PEPPER report yet? The Program for Evaluating Payment Patterns Electronic Report (PEPPER) were mailed on August 30 and have been slowly arriving at skilled nursing...
Reviewing the top 10 errors in rehab documentation
By
Shelly Mesure, MS, OTR/L
Apr 23, 2013
As a long-term care therapy consultant, I work on a lot of claim reviews and denials management with my clients. I’ve also read a lot of peer-review research articles related to this subject, and...
With new rules, more payment denials expected
By
Shelly Mesure, MS, OTR/L
Oct 02, 2012
Here it comes again! The Oct 1, 2012, federal regulatory changes will not only impact reimbursement but new reporting requirements also will multiply denials for skilled nursing providers across the country.
Love hurts PAC relationships
By
Renee Kinder
Feb 15, 2018
When it comes to developing strategic partnerships across the post-acute care spectrum, love can cloud our judgment.
5 rules of the rehab screen
By
Shelly Mesure, MS, OTR/L
Feb 25, 2014
What is the purpose of a rehabilitation screen? Very simply, we attempt to identify long-term residents’ needs and possible rehab potential. Somehow, we don’t really have an industry standard...
Caregiver Unburdened
By
Renee Kinder
Jun 07, 2018
Being a CNA, nurse, or therapist is also a big job requiring us to make decisions daily on when to care and when to allow those we serve to demonstrate their independence with tasks.