July 25, 2023

10 Factors that Could Trigger an Audit of Your Medical Records

With the ever-increasing litigious environment and mandatory Congressional oversight of commercial and government payers, physician supporting documentation should emphasize and include the type of service(s) provided, the time involved, special technology and equipment used, as well as any other complications encountered.Furthermore, because the government and insurance carriers routinely perform audits as mandated through the Fraud, Waste and Abuse program, it’s important for providers to be aware of problems that could cause them to come under…

Understanding PDPM and the NTA Component

As we prepare for the transition to the Patient-Driven Payment Model (PDPM), which is expected to occur on October 1, 2019, we have been reviewing the primary components that make up the Case Mix Index (CMI) for reimbursement. Previous articles in this series outlined the physical and occupational therapy component and the speech language pathology component. In this article, we discuss the non-therapy ancillary (NTA) component. The NTA component, together with the nursing and non-case mix…

MDS Accuracy: Importance of a Timely and Complete BIMS

In this Minimum Data Set (MDS) Accuracy Blog, we will highlight Sections and items in the MDS to review key misses that the experts at LW Consulting, Inc. (LWCI) have encountered. At LWCI, we thrive in partnering with clients to complete audits or provide consultative services to support concerns. As the experts at LWCI conduct audits, we identify commonalities with coding. Throughout this blog we will be sharing information on optimal MDS coding, based on…