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 to help prevent these denials.
Christina will first outline the top four denial trends identified in the SNF 5-Claim Probes. One significant trend is the lack of support for items coded on the Minimum Data Set (MDS). She analyzes various sections of the MDS, explaining why denials occur in these areas and offering guidance on how to avoid them. As Christina notes, “We find that anything that impacts payment and is coded is at risk of being audited for these probes.”
It is essential that those coding the MDS are well-versed in all relevant requirements and that documentation accurately reflects the needs of the residents. Christina recommends conducting periodic internal audits as a preventive measure. By having someone familiar with the RAI manual review patient records, facilities can ensure proper documentation and minimize coding errors.
