22Apr
Unpacking PDPM Denials: A Case Study on Managed Care, Medicare A, and RAC Audits
https://www.youtube.com/watch?v=zT0M_xPHQd8&t=1s Skilled Nursing Facilities are under increased scrutiny from CMS and Managed Care organizations, especially when it comes to PDPM claims. With 5 Claim Probes, RAC audits, and Managed Care audits becoming more common, the appeal process is more complex than ever. Navigating these challenges and preventing denials requires effective strategies and a deep understanding […]
07Mar
Elevating Quality Measures: Mastering Discharge Function Scores
https://www.youtube.com/watch?v=vs-zEo_3TXE In the world of skilled nursing facilities, one important measure of success during a Medicare subacute rehab stay is the new discharge function score. This metric evaluates how well residents progress during their stay, comparing their functional abilities on admission to those at discharge. It provides valuable insight into the rehabilitation process, highlighting whether […]
15Oct
2023-2024 MDS Changes: Maintaining Reimbursement Amid Evolving Requirements
https://www.youtube.com/watch?v=fadXgz4cabw&t=2s The MDS is a crucial component in the assessment and reimbursement process for skilled nursing facilities. Significant updates were made in 2023, with further changes introduced in 2024, prompting a closer examination of their implications for providers and the reimbursement landscape. In a recent webinar, Kevin Cezat, Director of Clinical Excellence for TMC, provided […]
29Aug
Unveiling SNF 5-Claim Probe Trends
https://www.youtube.com/watch?v=0LQ0-_baGsQ Over the past year, we’ve closely monitored the impact of the SNF 5-Claim Probes and have identified key trends and insights from the feedback received from our clients. In this session, we Christina Bruenderman, our Director of Denials & Appeals, will discuss the primary denial trends observed during these probes and provide actionable strategies […]
19Jul
I-SNP Advanced Webinar
https://www.youtube.com/watch?v=09dJnlG9yLg&t=1s It’s our second installment in our webinar series where we delve deeper into Institutional Special Needs Plans (I-SNP). Discover the advantages and potential challenges of selecting an I-SNP partner, explore enrollment strategies tailored for long-stay residents, and gain insights into optimal reimbursement options. We are thrilled to have Shayna Wasser, COO of Guided Care, […]
Recent Comments