AI Proves to be a Safety Net in Skilled Nursing Reimbursement
In skilled nursing, the line between accurate reimbursement and lost revenue often comes down to the smallest details. A missed ADL, a subtle change in oxygen use, or an overlooked function score fluctuation can translate into thousands of dollars in
PDPM Medicaid Transition Playbook: 5 Best Practices for Long-Term Care Leaders
As several states prepare to transition Medicaid reimbursement toward a version of the Patient‑Driven Payment Model (PDPM), long‑term care executives must be strategic and proactive. Below, we outline the current landscape in numerous states making the switch to Medicaid PDPM,
MedaSync Secures Strategic Investment from Omega Healthcare Investors, Inc.
MedaSync, a leading provider of AI-powered reimbursement optimization software for skilled nursing facilities, is proud to announce a strategic investment from Omega Healthcare Investors, Inc. (NYSE: OHI)
Stay Ahead of Key Changes to the Function Quality Measures
In the skilled nursing industry, function quality measures play a vital role in quantifying facility performance. These measures provide valuable insights for consumers and providers alike into resident outcomes, helping facilities improve care and comply with regulatory requirements. Recently, the two
The Critical Role of Section GG in Nursing Home Medicaid Reimbursement
For skilled nursing facilities (SNFs), precise and comprehensive documentation isn't just a regulatory requirement—it’s a driver of financial stability. One essential piece of this puzzle is Section GG of the Minimum Data Set (MDS). This section directly influences reimbursement rates
Discharge Function Score – A Simple Guide
The Discharge Function Score will be used to assess the functional status of patients at discharge. It is a comparison measure that measures whether a resident’s observed discharge function score meets or exceeds an expected discharge function score. The Discharge
Harnessing AI to Enhance Reimbursement Efficiency
The skilled nursing industry is inherently complex and data-intensive, where accuracy and efficiency are paramount. One area that requires exceptional precision is clinical data capture for reimbursement — the process of gathering and documenting detailed information about a patient's medical
Don’t Slip Up When Coding SLPs – Use These Tips Instead
The Patient-Driven Payment Model (PDPM) presents challenges and opportunities, particularly in coding for the Speech Language Pathology (SLP) component. Since the SLP case-mix index (CMI) multiplier ranges from 0.68 to 4.21, even one MDS coding misstep can be costly. This
October Ushers in a New MDS Era and Impacts State Medicaid
This October SNF/LTC communities implement an updated MDS Item Set, ushering in a new MDS era forreimbursement. The change marks the largest, most significant update to MDS 3.0 since its inception in 2010. 29 new and modified MDS items. Updates
New Clinical Reimbursement Market Report Reveals Coordinator Strain Will Negatively Impact Reimbursement
A lot has been written about the macro trends around shifting payment models, Managed Care growth, turnover and resource strains, which continue to impact reimbursement. But not much attention has been paid to the role and function of Clinical Reimbursement.