Attention SNFs! On May 4, CMS issued Pub 100-20 Transmittal 12015 mandating Medicare Area Contractors to conduct a 5-Claim Probe and Educate Review for all SNFs in their jurisdiction in response to the CERT program’s 15.1% improper payment rate in 2022.
The primary cause? MISSING DOCUMENTATION.
The MACs will begin reviews in June and continue on a rolling basis, starting with the top 20% of providers with the highest data-driven risk-profile. Do you know where your facility stands? Will your documentation stand up to a Probe Review?
Watch this webinar to learn about:
- Details of the memorandum and the reason CMS is mandating these reviews
- Timing and workflow implications for providers
- How to quantify your facility’s risk-profile, including the most frequent reasons for claim denial
- Step-by-step procedures to prepare for this critical initiative!
Meet your experts
Marc Zimmet
President & CEO, Zimmet Healthcare
Marc Zimmet is CEO of Zimmet Healthcare Services Group, LLC and its related group of entities. Marc entered the skilled nursing industry in 1993, beginning his career preparing Medicare cost reports and appeals. His firm now services a diverse client base approaching 4,000 post-acute care providers and industry stakeholders on matters relating to reimbursement-regulatory compliance, data analytics, quality improvement, strategic planning and market reform. Marc is an active member of many industry associations and serves on the Board of several healthcare provider, insurance and support companies.
Alicia Cantinieri, MBA, BSN, RN, RAC-MT, RAC-CTA, QCP, DNS-CT
VP of MDS Policy and Education, Zimmet Healthcare
With over 27 years of experience in long‐term care reimbursement and clinical consulting, Alicia is an expert and speaker on the Minimum Data Set (MDS), care planning, and clinical reimbursement and compliance. She is an AAPACN Resident Assessment Coordinator‐Master Teacher (RAC‐MT) and has earned Resident Assessment Coordinator Advanced (RAC‐CTA), QAPI Certified Professional (QCP), and Director of Nursing (DNS‐CT) certifications.
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10 Comments on “[On-Demand] CMS Claim Reviews: What SNFs need to know NOW”
Can you please email me the slide from the webinar today?
Hi Hillarie, click here to download the slides: https://www.simpleltc.com/wp-content/uploads/2023/05/Webinar-slides-Claim-Reviews-coming-in-June-Zimmet-Healthcare-Simple.pdf
Hello, the link is not working for the recording of the claims based webinar. Thank you.
Hi Kyle: Sorry you had trouble with the link. Here’s the direct link to the page… just register and you should see the recording/slides.
When will the link to recording be posted?
Hi Laura – The recording is posted. Just register on this page and you should see the recording/slides. Thanks!
Hello
I am attempting to watch this video on demand. The web page is saying it is no longer there . Is there an updated link to the video?
thank you
Hi Tammy – Here’s the direct link to the page… just register quickly and you should see the recording/slides. Let us know if you still have issues.
Hi,
I would like to have uploades recordnig from yesterday but I could not find it.
Hi Amy! Here’s the direct link to the page. Let us know if you still have issues.