A service designed to evaluate key systems throughout your organization that could impact Medicare compliance and related revenue. Polaris Group experts will evaluate your systems related to Admissions, MDS, nursing, therapy, billing, and ancillary vendor contracts. We will identify opportunities to improve revenue, decrease cost, and reduce compliance risk for denials, and we’ll even provide employee training and resource manuals.
Never in the history of SNF Reimbursement or Payment, has diagnosis coding affected, let alone, driven payment. Welcome to the world of PDPM! A missing or incorrect ICD-10 Code can impact your revenue under PDPM so it's important that your team knows how to identify accurate primary diagnoses. Polaris Group will provide an audit of current ICD-10 Coding practices and selection of Primary Reason for Admission as well as training to improve coding practices of your team. Audit will include ICD-10 coding including comorbidities, all of which impact Case Mix Group Assignment and PDPM payment. Training provided based on findings and ICD-10 best practices for PDPM.
Are you achieving accurate Case Mix Groups under PDPM for proper payment? We can provide your team with detailed feedback on coding accuracies as well as identify areas of risk for denials. Audit can include compliance with waiver rules as well as OBRA/Medicaid records to check for accuracy for PDPM data gathering. Training and Audit focus on all MDS PDPM related items including:
With PDPM, there are over 161items on the MDS which could impact payment. Now all the qualifiers for Nursing Component of the rate must be accurate, as well as comorbidities. Our audit and training will focus on the items below, to help you achieve greater MDS Accuracy for proper payment and reduce your risk for denials:
For questions or additional information, call us at 800-275-6252 or use the provided email submission form.