SNF Provider Preview Reports are available during a 30-calendar day preview period beginning from the date on which providers can access the report. SNF providers have until May 30, 2019 to review reports that contain data submitted between 2017 Quarter 4 and 2018 Quarter 3 for assessment-based quality measures, and between 2017 Quarter 1 to 2017 Quarter 4 for claims-based quality measures.
Three changes happened recently for therapists that billers should know about: Medicare’s outpatient therapy cap was repealed and the therapy threshold was lowered; new modifiers for therapy assistants were added; and the requirement for functional limitations reporting was removed.
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.