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Director’s Note

Apr 01, 2019
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AMBR Journal

Last month, as we were nearing the end stages of re-launching the association with its new name, Association for Medicare Billing and Reimbursement (AMBR) for Long-Term Care, we revisited the initial community outreach that our predecessors completed back in 2015. While we’ve come so far as an association and have witnessed and been a part of its progress, we wanted to make sure we were sticking with its roots and original purpose as we seek to join a more diverse group of professionals and expand our member benefits.

Board Member Spotlight

Apr 01, 2019
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AMBR Journal

 In our first issue of AMBR journal, we’d like to introduce you to one of the association’s board members: Maureen McCarthy, RN, BS RACMT, QCP-MT, DNS-MT, President/CEO of Celtic Consulting. AMBR’s Director of Content Brianna Shipley asked McCarthy to share how she got involved in long-term care billing, what being a successful career woman means to her, and what others who are interested in professional development should be doing to ensure they continue to grow in their field. Here’s what she had to say.

Surviving and thriving financially under PDPM

Apr 01, 2019
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AMBR Journal

Everything SNF providers knew under the RUG-IV casemix system is set to change when CMS’ new Patient-Driven Payment Model (PDPM) goes into effect on October 1, 2019. PDPM ushers in a new reimbursement paradigm that emphasizes treating the whole patient. The resident’s clinical complexity will drive payment. This is a massive shift away from the RUG-IV system, which reimbursed facilities based on the volume of resources provided (e.g., therapy minutes).

Get your compliance and ethics program up and running by the November deadline

Apr 01, 2019
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AMBR Journal

As of November 28, 2019, CMS will require SNFs to have a compliance and ethics program in place that meets one of CMS’ regulations in the Conditions of Participation (CoP).

Many SNFs have compliance and ethics programs in place, but November marks the first time that facilities can be subject to a survey tag or cited for not meeting the specific elements outlined in the CoPs, says Stefanie Corbett, DHA, postacute regulatory specialist for HCPro.

How should billers handle residents who have a long-term care policy?

Apr 01, 2019
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AMBR Journal

It’s not common for SNFs to admit residents with a long-term care insurance policy, so billers are often at a loss when one comes across their desks. Just like with any healthcare insurance plan, it’s important that billers know what these policies are, what they cover, and how to bill the insurance companies.

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