Unjustified payment denials and lowered rates, add insult to injury for providers with Managed Care beneficiaries. Maureen McCarthy, President and CEO of Celtic Consulting, spoke with McKnights Long-Term Care News about the uneven playing field skilled nursing providers are forced to contend with. Read the full article here. Would you like to learn where to verify … Continue reading
Reminder: On claims, not entering your patient’s name as displayed on their Medicare card puts you at risk to have claims returned as unprocessable. Some patient’s Medicare cards don’t display their full name due to a character limit. You are required to enter the patient’s last name, first name, and middle initial, if any, as … Continue reading
Cut-off to submit corrected MDSs for the Final Resident Roster Report is 5/15/22. Data included in this Final Resident Roster Report will determine CMI rates for payment dates 7/1-9/30/22. Use this time to verify that your MDS assessments captured the most accurate CMI for resident care. Celtic assists clients to implement best practices and have … Continue reading
You have until 5/15/22 to submit corrections. Are you capturing the most accurate CMI for resident care? Celtic supports our clients by identifying opportunities to optimize Case Mix system processes through analysis, targeted education and mentorship. Let’s discuss options to achieve your goals in the new system… Continue reading
Providers can view the data refresh on Care Compare and Provider Data Catalog. This refresh is based on quality assessment data submitted by Skilled Nursing Facilities (SNFs) to CMS from Q3 2020 – Q2 2021. Important to note, data for claims-based measure will continue to display data from Q4 2017 – Q3 2019 for this … Continue reading
Effective April 16, 2022, the U.S. Department of Health and Human Services will renew the Public Health Emergency (PHE) determination. To prepare for post-pay audits, providers should ensure supportive documentation is captured when using available SNF 1135 waivers. Celtic supports its clients in our rapidly changing industry by providing mentorship on the most up-to-date information. … Continue reading
Connecticut Providers- Two days remain to submit assessments to be included in Preliminary Case Mix Roster reports. All MDS assessments must be submitted and accepted by 11:59pm on Friday, April 15th to be included in the Preliminary Case Mix Roster reports. As a case mix consultant to nursing home associations and the State of Connecticut, … Continue reading
Q4FY21 SNF PEPPER results reveal areas of concern for improper Medicare payments. Administrators can access the Q4FY21 release now, which includes statistics through September 2021. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a valuable tool to guide auditing and monitoring practices as part of your compliance plan. Are you looking for a … Continue reading
CMS announced on 4/7/2022, it will terminate the identified waivers in two phases over the next 60 days. Click here for source details. Are you wondering what steps you’ll need to take to return to compliance with reinstated constraints? Celtic has helped numerous clients establish successful practices that conform to regulatory requirements. Contact us … Continue reading
After delays from the public health emergency, providers will finally see changes to Quality Measure thresholds in their 5-Star final reports. Act now! Preview reports have been released and offer a brief window for corrections to the final 5-Star reports. Celtic recommends providers examine preview reports (released 3/25/22) and make adjustments to any inaccurate assessments … Continue reading