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 … can we dispute a deficiency?
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Jan 25, 2023
CMS imposed a CMP for a deficiency that we do not agree with. Is there any recourse?
Ask the payment expert …. about the total nurse staffing measure
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Nov 11, 2022
Q: What is the Skilled Nursing Facility Value-Based Payment Total Nurse Staffing Measure?
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 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 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 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 … 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 overpayments
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Apr 10, 2023
Are the timeframes for investigating and repaying Medicare overpayments changing?