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Long-Term Care Skilled Services: How to Document for Proper Medicare Reimbursement
LongTerm Care Skilled Services How to Document for Proper Medicare Reimbursement Author:HCPro a division of BLR, Elizabeth Malzahn-McLaren To reduce your facility's risk of unwanted outcomes and ensure proper Medicare reimbursement for the type and number of skilled services provided, it's essential to submit claims appropriately and in accordance with the Centers for Medicare & Medicaid Services' (CMS) skilled services regulations. Don't miss out on Medicare reimbursement or put y... more »our facility at risk for fraudulent penalty charges and monetary recoupment! Long-Term Care Skilled Services: How to Document for Proper Medicare Reimbursement breaks down CMS' skilled services requirements and explains how facilities can best manage the daily operations that affect skilled coverage and necessary documentation. This book provides information for all staff members who play a role in determining and documenting skilled services and includes: - Easy-to-understand explanations of complex CMS rules and regulations regarding skilled services
- A topic-driven format enabling readers to research specific questions and conveniently and efficiently obtain complete and descriptive answers
- Examples of documentation for skilled services
- Guidance to help facilities receive the benefits and reimbursement they deserve
- Downloadable forms This book will help SNFs: - Identify common problems and challenges associated with skilled services and gain a better understanding of how to handle the major pain points
- Properly assess skilled services under the MDS 3.0
- Increase skilled census and improve their facility's reputation with the support of the entire staff
- Avoid under- and overpayments from Medicare with easy-to-understand explanations of complex rules and regulations
- Provide necessary skilled services to each resident through a complete understanding of eligibility requirements
- Accurately document skilled services using proven, time-saving solutions for proper Medicare reimbursement TABLE OF CONTENTS How to properly document for therapy and skilled nursing services
Causes medical necessity denials and potentially subsequent audits
Impact and necessity of benefit exhaust claims and no-pay claims
Certification/recertification completion
Medicare rules and regulations under the MDS 3.0
Strategies to maintain skilled census
Relationship to diagnosis coding and usage (e.g., V codes)