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 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 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 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 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 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.