Reimbursement

 

 

KB-PASS can audit your organization's record to confirm that assessments are being completed timely and accurately and at the same time optimizing reimbursement. As organizations focus on maximizing reimbursement, they also need to be cognizant that CMS in now scrutinizing the accuracy of the MDS.  Our team will work with providers to achieve not only financial success but at the same time ensure data is accurate and valid. 

 

Services include:

  • MDS Process

  • Maximizing & Managing Reimbursement for Medicare

  • PPS coding and scheduling

  • MDS coding issues significant to PPS reimbursement

  • RUGS IV classification clinical indicators

  • RUGS IV ADL scoring

  • Reconciling State/CMS reports

  • Skilling Criteria

  • Billing and Revenue cycles

  • ICD 10 Transitioning

 

 

Maximizing & Managing Reimbursement for Medicaid

  • OBRA coding and scheduling

  • MDS coding issues significant to case mix reimbursement

  • ADL training

  • Reconciling State/CMS reports

 

 

Medical Review Assistance

  • Medicare, Medicaid and Insurance Mock Audits utilizing the Triple Check System

 

Quality Measures (QM). The Consultant will provide the following education related to Quality Measures:

  • How assessments are used to generate QMs

  • QM record definitions

  • Basic calculation of QMs

  • Risk Adjustment and the impact on QMs

  • How to interpret CASPER reports

  • Short stay vs Long stay measures

  • QMs triggered by MDS coding items

 

Medical Record Audits

  • Additional development request assistance

  • Medical Record review assistance