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Posting Date: 06/07/2019
Opt Out Search
Opt Out Search Doctors/practitioners included in the opt out database are those who have elected to “opt out” of the Medicare Program and enter into private contracts with Medicare beneficiaries if specific requirements are met. By “opting [...]
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Posting Date: 08/27/2021
Physicians or Practitioners Eligible to Enter Into Private Contracts
Physicians or Practitioners Eligible to Enter into Private Contracts Eligible physicians and practitioners Physicians Physician assistants Nurse practitioners Clinical nurse specialists Certified registered nurse anesthetists Certified [...]
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Posting Date: 03/28/2024
Skilled Nursing Facility Town Hall Question and Answers
Skilled Nursing Facility Town Hall Questions and Answers Are daily notes required for skilled rehabilitation? Answer: Daily notes for rehabilitation are not required, however, they do support that therapy performed was skilled and [...]
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Posting Date: 08/03/2023
Skilled Nursing Facility Educational Center
Skilled Nursing Facility Educational Center As part of the effort to lower the SNF improper payment rate, CMS has initiated a five claim Skilled Nursing Facility Probe & Educate allowing for outreach to all Medicare billing SNFs in the [...]
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Posting Date: 08/03/2023
Coverage Requirements
Coverage Requirements Eligibility, preadmission, and 30-day transfer are components of coverage requirements for Skilled Nursing Facilities. There are several components to each of the coverage requirements; please utilize the links below to [...]
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Posting Date: 08/03/2023
Required Documentation
Required Documentation Table of Contents Required Documentation The medical record should contain patient specific information detailing Certification and Recertification Requirements Signature Requirement for Certifications and [...]
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Posting Date: 08/03/2023
How to Prevent Common Skilled Nursing Facility Denials
How to Prevent Common Skilled Nursing Facility Denials This resource was developed to increase awareness and educate SNFs on the top errors found by our Medical Review team. The information includes suggestions to ensure documentation [...]
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Posting Date: 02/26/2021
How to Find and Respond to Post Payment Review ADR
How to Find and Respond to Post Payment Review ADR Table of Contents How to Find and Respond to Post Payment Review ADR Responding to Post Payment Review ADR Steps to View and Print ADRs from FISS/DDE Provider Online System Related [...]
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Posting Date: 06/26/2024
Patient Driven Payment Model
Patient Driven Payment Model Table of Contents Assessment Schedule Administrative Presumption Lookback Period (Observation Period) Examples General PDPM Resources [Return to Top] Assessment Schedule Learn more about the [...]
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Posting Date: 12/15/2021
NGS Medical Review Process
NGS Medical Review Process Medicare contractors, like NGS, operate the medical review program to prevent improper payments and protect the Medicare Trust Fund. Medical reviews involve the collection and clinical review of medical records and [...]
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