Understanding PDPM and HIPPS Coding

Health Insurance Prospective Payment System rate codes, known as HIPPS codes, represent specific sets of patient characteristics (or case-mix groups) on which payment determinations are made under several prospective payment systems (PPS). These HIPPS codes are reported on claims to insurers. The language of the Patient Driven Payment Model (PDPM) HIPPS coding is complex. The HIPPS code is only five digits however there are many combinations of those digits under PDPM. Once you understand what each digit…

The Benefits of a Liquid Workforce

I am an unabashed fan of podcasts. My weekly roundup includes nearly two dozen shows. I listen to them while I walk, while I work, and while I relax. It is certainly safe to say that I listen to more podcasts than I have ever watched television. One of my favorite series is “The Uncertain Hour.” It is an investigative journalism podcast, where the creators take a deep dive into topics impacting our society. The…

Understanding the Benefits of an External Audit for SNFs

Here we are in 2024 and costs are skyrocketing! If you are the owner or management operator of a Skilled Nursing Facility (SNF), you know this more than ever. Staffing is at the top of everyone’s list of costs – and it only continues to increase! Providers are also feeling the pinch of the increased cost of infection prevention and the usual price increases for dining, housing and supplies. All of these factors combine to…