A new, unique Medicare Beneficiary Identifier (MBI) replaces the Social Security Number-based Health Insurance Claim Number (HICN) on the new Medicare cards. CMS created a poster that clarifies misunderstandings surrounding the MBI.
Fourth quarter FY 2018 Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) are available for download through the PEPPER Resources Portal. These reports summarize provider-specific data statistics for Medicare services that may be at risk for improper payments. Use your data to support internal auditing and monitoring activities.
CMS recently clarified that the new Medicare Beneficiary Identifier (MBI) uses numbers 0-9 and all uppercase letters except for S, L,O, I, B, and Z. They exclude these letters to avoid confusion when differentiating some letters and numbers (.e.g, between “0” and “O”).
These audits occur generally five days after an admission (not too early/not too late). The goal is to capture the completion of assessments, care plans, accuracy in medication reconciliation, and orders from the hospital. Depending on the findings, an opportunity for correction via late-entry documentation can occur to help ensure a clean claim. Download the Admission Audit.
CMS released the new HIPPS code to be used by SNFs billing on Type of Bill (TOB) 21X and hospital swing bed providers billing on TOB 18X (subject to SNF PPS) effective October 1, 2019, with the implementation of PDPM.
The Centers for Medicare & Medicaid Services (CMS) released several proposals in a blog post dated February 8, 2019, to help increase interoperability between hospitals and LTC facilities and remove silos that prevent SNFs and nursing homes from getting the information they need to care for patients. The agency is accepting comments on the requests for information and proposed rule until early April (exact date to be announced).
We’re conducting a brief survey to better understand your PDPM training needs. The first five participants who take the survey will receive a free, on-demand webinar of your choice. This is a quick survey and we greatly appreciate your feedback.