Beyond Keywords: AI for Reimbursement Accuracy in Long-Term Care
For years, many healthcare organizations have relied on keyword search tools to comb through clinical notes. On the surface, it seems logical: type in a diagnosis, find the word, and capture it for reimbursement. But real-world documentation isn’t that straightforward
From Manual Reimbursement Audits to Proactive, Continuous Intelligence
For decades, skilled nursing leaders operated in a reactive cycle. MDS teams submitted assessments, operators waited for the billing cycle to close, and only then could they see whether they had hit their reimbursement marks. By that point, it was
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,
Why SNF’s Must Evolve Their Multi-Payer Approach
So Many Payers, So Little Time. The SNF industry and healthcare in general has historically adopted large changes slowly over time. The last several months and impact of the pandemic on SNF’s has changed all of that… Trends like telehealth
Pre-Service: Achieving Success Despite Increasing Complexity
As a Nursing Home Operator, You’re Likely Facing More Challenges Than Navigating PDPM As SNF owners and operators, we are constantly focused on new rules; increasing regulation, elections, and demographic changes; and most importantly, filling beds and providing high-quality care. We
Non-Therapy Ancillaries: From Complexity to Opportunity
PDPM is Here, But Are We All Aboard for the Benefit? It’s finally January, which means most of us have survived the initial onslaught of PDPM mania. We put in the work — watched the webinars, attended the training sessions, educated
Preparing for PDPM? Here Are 3 Steps You Can Take Right Now
New System, New Challenges This October, the Patient-Driven Payment Model (PDPM) will go live — replacing the old RUG-IV system that’s been in place for more than two decades. We’ve all seen it coming, but as the new reimbursement model draws
Need to Improve Managed Care Efficiency at Your SNF? Technology Is the Answer
As a Nursing Home Operator, You’re Likely Facing More Challenges Than Preparing for a New Reimbursement System Across the country, skilled nursing facilities are working tirelessly to do what they do best: provide outstanding care for patients and their families. Along
For SNFs of All Sizes, Internal Communication Matters — Here’s Why
All too often, SNFs become hyper-focused on the day-to-day tasks involved with providing patient care, keeping insurance companies up-to-date, working with patients’ families, and trying to get information for billing purposes. It’s a lot to handle, which is why efficient