How do Healthcare Auditors Find Mistakes? Meet Benford’s Law

Likely, you have never heard of Benford’s Law, but we can guarantee that it has impacted your daily life in more ways than you can ever realize. The principles of the law have been baked into auditing practices, accounting systems, and yes, even healthcare platforms. But, what is it? Benford’s Law, also known as the “First-Digit Law,” is a mathematical principle that states that in many naturally occurring datasets, the leading digits of numerical values…

Concurrent Therapy Group

Group vs. Concurrent Therapy Part 2: Are You Documenting Accurately?

In Part 2 of this two-part blog series “Group vs. Concurrent Therapy: Are You Documenting Accurately?” we will discuss actual documentation of examples that may not support group and concurrent therapy as skilled and reasonable. In Part 1, we reviewed the definitions of group and concurrent therapy. Both definitions can be found in the Resident Assessment Instrument (RAI) Manual, Pages O-23-O-25. To refresh your memory, the Centers for Medicare & Medicaid Services (CMS) currently defines…

Concurrent Therapy Group

Group vs. Concurrent Therapy Part 1: Are You Documenting Accurately?

Since October 1, 2019, for Medicare A recipients, the Resource Utilization Groups (RUGS) IV is out and the Patient Driven Payment Model (PDPM) is in. The first two years of the transition were complicated by COVID and the PHE. But since May 2023 when the PHE ended, things have been getting back to normal. It is important to remember that although the reimbursement model has changed, the regulations outlined in the Centers for Medicare &…