The Impact of GG Accuracy to Medical Review
Lack of substantiation of MDS Section GG is frequently a citation among medical review findings, especially from Managed Care audit contractors. In absence of GG supporting documentation, reviewers will determine a resident’s function score to be consistent with independent performance. Tips for improving GG documentation follow. As review of GG items is often a quick […]
Medical Review Terminology
To many, the multiple contractor requests that comprise the world of medical review are simply summarized as “ADRs” – for accuracy, it’s important to identify and understand the components. A summary of impactful requests follows. Proactive Steps to Ensure Requests are Received
The Link Between Triple Check and Medical Review
Why is triple check so important? As medical review may impact efficiency of current reimbursement, or sustenance of payment previously received, emphasizing a comprehensive triple check process will contribute to organizational integrity. Getting claims right at triple check, versus during subsequent medical review, is a compelling argument toward site specific performance and enterprise success.
Shipwrecked or smooth sailing? How to stay on course with GG & PDPM
In this webinar, we share findings on the most missed PDPM capture items and GG issues, including tips, strategies, and critical resources for success.
How to Speak the Same Language for Section K Coding: NACs and SLPs
When a nurse assessment coordinator (NAC) reviews the speech language pathologist (SLP) evaluation notes and encounters the term globus sensation, he or she may not even consider that the phrase could indicate a potential swallowing… Download the Article | Go to the Article (Membership Required)
What’s all this about GG? It’s Game Time!
Resources Webinar Handouts CMS GG Training Video CMS GG Scoring QRP Pocket Guide MDS Manual MDS 3.0 Item Set Version 1.18.11 | MDS 3.0 Resident Assessment Instrument RAI Manual CMS’ Post on MDS 3.0 RAI Manual Draft MDS 3.0 Item Set V.1.18.11 RAI Manual State RAI Coordinator: Appendix B 08252022 (PDF) State RAI Coordinator: Changes to […]
Part B Assistant Cut Advocacy Gaining Momentum with Announcement on September 7 from NASL and Their Coalition Partners
Advocacy toward elimination or reduction of the assistant cuts has renewed energy with the findings of this commissioned report. We applaud and support this effort to remove barriers to cost-effective access to care! “Results show that the costs and savings generated through the change in supervision for PTAs and OTAs in the outpatient setting could […]
Oh My Stars! What Just Happened?
QRM Redefines Roles Under PDPM
QRM, is a Rehab Management Organization that is progressively changing care delivery in the post-acute-care sector. Read More…