HOME
Polaris Group
header
 
Consulting Services & Solutions
Overview
Patient-Driven Payment Model (PDPM) Readiness Services
Medicare Consulting
Nursing Consulting
Therapy Consulting
Financial Consulting
OBRA Mock Survey
Medicare Billing Services
Apollo RM: Risk Management
RAC Audit
Interim MDS
Permanent Recruitment Services
Interim Placement Services
Cost Report Services
False Claim Risk Assessment
Corporate Compliance Consulting
Independent Review Organization (IRO)
Assisted Living Facility Consulting
Additional Services
Call us at 1-800-275-6252
Full PDPM MDS Audit  

With PDPM, there are 161 items on MDS which could impact payment.   Now all the qualifiers for Nursing Component of the rate must be accurate, as well as co-morbidities.  Our audit will focus on the accuracy of these items sets, which include co-morbidities for NTA and SLP component of the rate; and the qualifies for Nursing component.   Polaris Group has expertise in coding of MDS, and will apply these skills to the audit.   Items audited will include but not be limited to: Mood Indicators, isolation, multiple diagnosis checks, nutrition qualifiers, nursing restorative, GG, and ICD-10 selection. 

Objectives:

  • Provide an audit for MDS accuracy of Items on MDS that could impact PDPM CMGs.
  • PDPM qualifiers are through-out the MDS performed by nursing, dietary, and social services.
  • Identify weaknesses in supporting documentation of coded items, to prepare to MAC/RAC audits in the future.
  • Identify any under-coding practices.  
  • Provide Training on PDPM

Audit:

  • Sample of discharged Part A residents 5-day MDS and claim to obtain all RUGs billed.
  • Audit up to 161 items on MDS for accuracy and supporting documentation.
    • Will include GG and ICD-10 Review
  • Identify any under-coding of items which would impact PDPM CMGs
  • Determine financial impact comparing RUG revenue to PDPM revenue for charts audited. 
  • Determine change in CMGs related to coding errors and PDPM revenue impact
  • Share findings of audit, coding impact, and recommendations.

Benefits of Audit and Training:

  • Expert analysis of current coding practices to identify areas for improvement
  • Financial Impact Analysis for charts audited.
  • Improved understanding of how PDPM will work
  • Ability to create strategies to prepare for PDPM

Deliverable:

  • Audit findings and recommendations for coding accuracy.
  PDPM Training - How it works
  PDPM Right Start - Comprehensive Services
  Focused ICD-10 Coding Accuracy Training and Audit
  MDS Coding Accuracy for PDPM Training
   Focused GG Audit and Training
  PDPM to RUGs Financial Impact Analysis
  Transition Services
Other PDPM Support Services:
   Medicare and PDPM Compliance Audits
  Key Indicator Trend Reports - Claim data trending services
  PDPM Manual with policies and procedures
  Billing Manual with policies and procedures
  Solution Center Hotline
Top of pageTop of page