Ask the payment expert … about clinical qualifiers
By
Patricia Boyer
Oct 01, 2013
Most of our residents are covered under rehab services, so why do we need to worry about capturing clinical qualifiers?
Ask the payment expert … about MDS staffing
By
Patricia Boyer
Sep 01, 2013
We recently lost our MDS nurse and didn’t know what to do, as no one else knew how to do MDSs. What should we do differently now?
Ask the payment expert … about RAC nursing home audits
By
Patricia Boyer
Aug 01, 2013
We keep hearing about RACs in skilled nursing homes but we haven’t seen any in our state, so why should we worry about them?
Ask the payment expert … about monitoring therapy services
By
Patricia Boyer
Jul 01, 2013
Q: What should an administrator do to monitor therapy services in his or her facility?
A: The main fact to remember is that you are responsible for what happens in your therapy department, even if you...
Ask the payment expert … about quality and reimbursement correlations
By
Patricia Boyer
Jun 01, 2013
How can the Centers for Medicare & Medicaid Services correlate quality of care and reimbursement?
You always need to remember that Medicare is an insurance plan. As such, Medicare has rules, just like...
Ask the payment expert … about the observation stay loophole
By
Patricia Boyer
May 01, 2013
We’ve had problems with residents being caught in the hospital “observation stay loophole.” What can we do to ensure they qualify for coverage at our facility?
Ask the payment expert … about inaccurate MDS therapy information
By
Patricia Boyer
Feb 01, 2013
What happens if my therapy company makes an error on the MDS and as a result, a change of therapy was missed? Are we still responsible?
Ask the payment expert: Why do we have so many A’s in our ADL coding?
By
Patricia Boyer
Jan 02, 2013
The new RUGs-IV scoring methodology has a strong tendency to score your ADLs lower.
Ask the payment expert: How can I make sure that my Medicare claims are correct?
By
Patricia Boyer
Dec 02, 2012
I recommend every facility that gets reimbursement from Medicare complete a Medicare audit annually. You want to look at yourself the same way the government does.
Ask the payment expert: How well are the new MDS rules working?
By
Patricia Boyer
Oct 01, 2012
Now that we are a few months after the April MDS assessment changes, how are rules working for facilities?