Here’s Why You Must Begin Prepping Now for Skilled Nursing PDPM Implementation

Patient-centered care: Recently it’s a term you’ve heard promoted widely in the healthcare field, along with “data-driven” and “real world evidence” (RWE). The Centers for Medicare & Medicaid (CMS) is catching on to the trend and updating its programs accordingly. For instance, CMS has replaced the existing case-mix classification methodology—the Resource Utilization Groups, Version...

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New Year’s Resolution for Your LTC Facility: Prep for CMS Survey Process

The Centers for Medicare & Medicaid Services (CMS) expects your long-term care facility (LTCs) to uphold certain requirements for Medicare participation—and conducts surveys to see that you are. Though the Phase 2 of CMS’s regulatory program took effect back in November 2017, it introduced an evaluation survey that some facilities still struggle to understand....

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Medical Necessity Guidelines: Streamline the Physician-to-Payer Process

Want to know one of the easiest ways to prevent payment denials? Here’s a trick: Understand “medical necessity” inside and out, especially with respect to ICD-10 coding, and you’ll be on your way to spotless claims. Not only that, but you’ll be able to confidently explain issues like “not medically necessary” versus “not covered”...

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Perfect Your Procedural Expertise to Cope With 2019 CPT Code Changes

If your New Year’s resolution includes giving yourself a professional skills upgrade, there’s no better way than to download new coding know-how from the experts. And that’s more convenient than ever to do: The ProfEdOnDemand 2019 Coding Updates Virtual Boot Camp—the most information-packed coding event of the year—is now available on demand. What it...

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‘Dear Physician’: Updates to DME Documentation Requirements Hold You Accountable

The Centers for Medicare & Medicaid Services (CMS) recently updated the durable medical equipment (DME) documentation guidelines. And the revisions are significant, as you’ll discover in the latest CMS documentation guidelines webinar presented by coding director Lynn Anderanin. Arguably one of the biggest changes involves four DME Medicare Administrative Contractors (MACs) and a revised...

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CMS Rules 2019: How (And When) New Hospital Discharge Planning CoP Will Affect You

How closely related in your mind are the words “discharge planning” and “admission”? According to the Centers for Medicare and Medicaid Services (CMS), they should be closely related, if not intertwined, as you’ll find out in the latest hospital discharge planning webinar by health care consultant Toni Cesta. Regardless of how far your practice...

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