Welcome to The Billers' Association For Long-Term Care

The Billers’ Association for Long-Term Care is a membership community created specifically for long-term care billing professionals. This national association provides members with a resource of continuously updated tools, billing-specific education, and reimbursement and regulatory guidance. Become a member today and join your long-term care billing colleagues as you navigate the evolving world of post-acute care billing.

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Featured member resource: Admission Audit

Feb 15, 2019
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The Bottom Line

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 vows to stop hospitals from blocking nursing home requests for patient information

Feb 15, 2019
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The Bottom Line

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).

Take this 5-minute survey for a chance to win a webinar

Feb 15, 2019
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The Bottom Line

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.

 Here's the URL to take the survey. Click the link or copy and paste it into your browser: https://www.surveymonkey.com/r/B53QM5G.

Please complete the survey before Monday, February 18 to be entered to win. Thank you!

States now required to conduct at least 50% of off-hour surveys on weekends for facilities with potential staffing issues

Jan 25, 2019
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The Bottom Line

A list of facilities with potential staffing issues is being provided to CMS regional offices and state survey agencies to support survey activities for evaluating sufficient staffing, according to a memo released by CMS back in November, 2018. The memo states that “while CMS is encouraged by facilities’ efforts to improve staffing,” payroll based journal (PBJ) data has raised a few concerns, prompting them to inform state survey agencies of facilities with potential staffing issues. These issues include facilities with significantly low nurse staffing levels on weekends and facilities with several days in a quarter without an RN onsite.

CMS alert: CY2019 DMEPOS fee schedule update and KX modifier amounts

Jan 18, 2019
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The Bottom Line

CR 11064 (MLN Matters) provides the Calendar Year 2019 annual update for the Medicare DMEPOS fee schedule. The update includes information on the data files, new and deleted HCPCS codes, adjusted fee schedule amounts, and other information related to the update of the fee schedule. Click here to read the full article.

What you need to know about the updated MDS items sets for 2019

Jan 11, 2019
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The Bottom Line

CMS posted a new DRAFT version of the 2019 MDS item sets (v1.17.0) last week. This version is scheduled to become effective October 1, 2019, giving facilities until then to update their software with the new MDS questions and answers. Downloadable files can be accessed here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html

HCPro’s post-acute regulatory specialist Stefanie Corbett, DHA, reports the following changes.

Triple check monthly billing review

Jan 11, 2019
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The Bottom Line

Implementing a triple check process in your facility not only helps improve therapy and nursing documentation, but can also assist in monitoring and identifying areas of discrepancy and opportunity to improve the management of the Medicare Part A process. Performing a monthly billing review can help ensure that critical elements are present on the MDS to ensure optimum payment. Download our triple check monthly billing review tool to keep each item organized and tracked.

Don’t let your HIPAA policies and procedures go stale

Jan 11, 2019
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Billing Alert for Long-Term Care

For HIPAA covered entities (CE) that maintain poor policies and procedures related to HIPAA compliance—those that are unfinished in draft form, not updated in years, and basically not followed to the letter—their lassitude has cost them dearly.

Just look at some of the settlements OCR has struck with CEs and business associates (BA) in the past five years. Many of those settlements include findings that organizations had poorly maintained policies and procedures. This has increased the settlement amounts and in turn led OCR to issue strict consent decrees requiring these entities to update and maintain their HIPAA-related policies and procedures.

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