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November 2019
Reimbursement Defense – Auditors are Here to Stay
Despite systemic change from therapy as payment driver, third-party reimbursement compliance audit risk may intensify under PDPM. Instead of defending Ultra High delivery, we expect auditors to focus on far more dynamic (and objective) payment drivers that will be harder to overturn on appeal. This session will review strategies for maintaining compliance (i.e. accurate documentation) for new risk areas specific to SLP end splits, nursing RUG qualifiers and non-therapy ancillaries.
Find out more »December 2019
Next Generation Analytics & Early Benchmarks: Using the UB-04 to Measure PDPM Performance
The Medicare claim is the new “it” source document for PDPM interventional analytics. The UB-04 contains both the detailed financial and clinical metrics required to quantify quality/value with reliable comparative integrity. Additionally, detailed Component scores, ancillary charges, diagnoses codes and other previously overlooked “fields” enable reimbursement logic testing without the “false positives” generated from other sources. Tune in to this session to identify revenue & outcome opportunities by distilling the subtleties of UB-04 coding patterns, then benchmark your facility’s performance…
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