Ask the Payment Expert? Why am I not receiving incentive payments for FY 2019?
By
Patricia Boyer
Nov 02, 2018
Why am I not receiving incentive payments for FY 2019 SNF Quality Reporting Program (QRP) and Value-Based Purchasing (VBP) are separate, but related, programs. QRP is required by the IMPACT ACT to collect...
Ask the payment expert: I am seeing an increase in Medicare Replacement Policy additional document requests....
By
Caryn Adams
Oct 01, 2020
I am seeing an increase in Medicare Replacement Policy additional document requests. How should we respond?
Ask the payment expert … about pending removal of Section G
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Dec 05, 2022
What is the impact of Section G being removed from the MDS?
Ask the payment expert: Now that PDPM is in full swing, what should be on my radar for 2020?
By
Caryn Adams
Nov 12, 2019
Now that PDPM is in full swing, what should be on my radar for 2020? There is always one more thing on the horizon. This month is the rollout of the Phase 3 requirements of the conditions of participation,...
Ask the payment expert: Is there a penalty if a SNF resident receives more than 25% of his or her therapy...
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Mar 01, 2022
Is there a penalty if a SNF resident receives more than 25% of his or her therapy in a concurrent or group setting?
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: What changes are coming to the 5-Star rating with the new refresh?
By
Caryn Adams
Apr 01, 2020
What changes are coming to the 5-Star rating with the new refresh?
Ask the payment expert … about VBP incentive pay
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
May 03, 2023
How should we manage SNF value-based purchasing measures to receive incentive payments?
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: PDPM’s flexibility
By
Caryn Adams
Jan 05, 2020
Can you comment on the Patient Driven Payment Model’s flexibility? Facilities might reduce traditional therapy while adding group/social exercise classes and then have therapists guiding the curriculum...