October 1, 2019
PDPM Triple Check Process and Billing Accuracy
1:30 p.m. – 2:45 p.m. CT
This 1.25 hour webinar will review best practices to decrease potential billing errors and promote accurate reimbursement for PDPM claims through internal interdisciplinary auditing processes. Key roles of interdisciplinary team members in completion of a collaborative triple check process and key data collection, billing, and monitoring process pertinent to PDPM will be emphasized.
At the conclusion of the webinar, the learner will: (1) Review best practices for internal audit of PDPM claims prior to submission to decrease potential billing errors and promote accurate reimbursement; (2) Identify key roles of the interdisciplinary team in completion of a collaborative triple check process of items/data elements impacting PDPM reimbursement; and (3) Review key data collection, billing, and monitoring processes important to PDPM reimbursement accuracy, including but not limited to understanding the updated HIPPS codes and validating UB-04 accuracy prior to submission.
Owners and corporate teams, directors of nursing, assistant directors of nursing, nurse managers, nursing home administrators, nursing staff and leaders, quality assurance directors, medical records, MDS staff, therapy staff, and business office and finance in nursing facilities.
Shelly Maffia, MSN, MBA, RN, LNHA, QCP, Clinical Consultant – Shelly Maffia is a registered nurse and nursing home administrator with more than 15 years of experience serving in long-term care leadership and consulting positions. She earned the QAPI Certified Professional (QCP) credential from the American Association of Nurse Assessment Coordination (AANAC), which was established to promote the highest standards for QAPI program implementation in the long-term care profession.
Amie Martin, OTR/L, CHC, RAC-CT, Clinical Consultant – Amie Martin is an Occupational Therapist and Compliance Officer with more than twenty years of experience serving in long-term care leadership positions and as a clinical program specialist. Amie is certified in health care compliance. She has successfully partnered with providers to develop and implement compliance and ethics programs, achieve five-star survey results, and ensure Medicare reimbursement accuracy as Founder and President of Proactive Medical Review Consulting.
Eleisha Wilkes, RN, RAC-CT – Eleisha Wilkes is a registered nurse with more than fifteen years of experience in long-term care. She has served as a director of nursing, case manager, and resident assessment coordinator with extensive responsibility and success in driving QA in the areas of person-centered assessment and care planning through effective systems, staff development, and interdisciplinary team collaboration. She now serves as an RN Clinical Consultant with Proactive Medical Review & Consulting, LLC.
Proactive Medical Review & Consulting assists post-acute care providers in ensuring compliance with regulatory standards and promoting measurable care excellence. Proactive specializes in SNF risk assessment, Quality Assurance Performance Improvement projects, medical record review services, and staff development to promote care quality and effective clinical documentation.