OPTIMIZING RESTORATIVE SERVICES

Have you been told that the lower 18 MDS triggers are off limits for SNF’s? Are the top 21 rehab categories the limit for most of your Medicare billed days? Are there no therapy minutes for rehab nursing?

Since the 18 MDS triggers are not comprehensive enough for a complete assessment of a qualified beneficiary’s medical needs, our Consultants teach the Medicare Case Manager how to use the Caregiver OM System (including 84 additional problem templates) to assess a patient’s Medicare coverage and need for restorative services. This gives you a complete blueprint for Medicare payments, which results in a longer restorative period with positive outcomes. This also justifies additional billing to Part A and keeps them off Medicaid or Part B until appropriate. The Caregiver Consultants are also on call by phone to answer coverage questions and discuss specific cases prior to the weekly Utilization Review meeting. Login and Read more...