Claim Reviews coming in June

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 recording 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!