Billing Medicare Part A for Ancillary Therapy Services - a change in what units represent

Focusing on Medicare’s coverage and payment for ancillary therapy services, Transmittal 2239 (CMS Manual, Pub 100-04 Medicare Claims Processing, issued June 14, 2011, Billing SNF PPS Services, 30.4 - Coding PPS Bills for Ancillary Services) states, effective August 1, 2011, “For therapy services, that is revenue codes 042x, 043x, and 044x, units represent the number of calendar days of therapy provided.  For example, if the beneficiary received physical therapy, occupational therapy and speech-language pathology on May 1, that would be considered one calendar day and would be billed as one unit.” (Italics added.)

In the Spring of this year, I used baseball as a metaphor for the “game of Long Term Care.” At that time I said that providers were “going to have to step up to the plate and respond swiftly and powerfully to the curve balls of regulatory changes, the sliders of reimbursement, the change-ups of market pressures, and the fast balls of competition.” Little did I know at the time that the term, “sliders of reimbursement,” was going to be uncomfortably prophetic. Because of the drastic “adjustments” to Medicare reimbursement and declining Medicaid rates, the slider is real – a potential slide downhill, that is; they’re game changers. I would like to take the baseball metaphor one swing further.

Personal productivity devices, such as desktops, laptops, smartphones, and tablet PCs, and the data they generate and retrieve have contributed to a wealth of information and…risks for Long Term Care. If Information Technology (IT) managers are unable to monitor, manage, and protect productivity devices, software distribution, and how information is exchanged and filed, providers run a considerable risk of data loss, non-compliance, and potentially fatally damaging their operations. Implementing sound hardware and data management practices is the responsibility of all providers. IT Asset Management (ITAM) embraces the technology and best practices that can help IT Managers with this critical task.

I argue that Accountable Care Organizations (ACOs) do not represent a health care delivery revolution, but an evolution. Based on my experience in LTC and what I’ve been reading on the Internet, ACOs appear to be an evolutionary variant of the species known as HMOs. Regardless, ACOs represent a significant change to health care delivery. The ACO model will have a sweeping impact on how health care is planned for, delivered, documented, reported, and paid for. It follows that for an ACO to work, information technology serves as the glue that holds it together; those providers who have successfully worked with HMOs can attest to the critical role IT plays. Participation as ACO members will require providers to carefully evaluate what such participation will have on their respective IT systems.

It’s that time of year again.
In 2011, the desolation and loss of life in the wake of the massive tornados in Joplin, MO, in Tuscaloosa, AL, and other states have captured the attention of LTC providers across the country with the realization that disasters can strike anywhere, at anytime. They recognize the need for a real-world, workable, and well-rehearsed disaster preparedness and recovery plan that at least minimizes, if not prevents, injury and loss of life during and after a disaster.

How the Cloud can help you meet today’s opportunities more rapidly

OK. So what is “the cloud?” In general, cloud computing refers to anything that involves delivering hosted services over the Internet. Because the cloud symbol has been used for a long time in flowcharts and diagrams to represent the Internet, the use of the term, “cloud computing,” is logical. So what’s the recent buzz about cloud computing - especially for health care providers?

Introduction

An operator of over 35 facilities in four states has been using its digital dashboard to effectively manage census, labor, collections, and MDS information. The company’s BI/digital dashboard project manager cited three reasons that it has become an increasingly successful day-to-day management tool.

Hitting a home run with Business Intelligence and Analytics

I’m a sports fan. Yep. No doubt about it. Spring means not only hay fever, but baseball fever. I love to see a good solid swing and to feel the excitement of watching the gravity-defying flight of the ball as it soars over the outfield fence and into the bleachers. There’s nothing like a home run! Unlike baseball, however, the game of Long Term Care is not seasonal and if providers want a sporting chance, they’re going to have to step up to the plate and respond swiftly and powerfully to the curve balls of regulatory changes, the sliders of reimbursement, the change-ups of market pressures, and the fast balls of competition year around. It means split-second decision-making and lightning-fast responses. More to the point, providers must interpret real-time data, employ sound decision-making best practices, and implement solutions. The key? Business Intelligence (BI) and Analytics.

Introduction

“Oh, please! What does a man know about labor pains?” Yes, absolutely nothing, no matter how much empathy a man like me may have. But that is obviously NOT the “labor pains” implied in this blog’s title. The labor pains I am referring to apply to such agonies as overtime, being expensively above or dangerously below the daily labor budget, staffing with and paying for contract labor, such as pool or registry nurses, and any other discomforts that are related to the day-to-day staffing and operations of a long term care facility. How can providers leverage Business Intelligence (BI) to help relieve them of their “labor pains?” Let me suggest five ways.

Overview In our previous blog, “Discover the Wealth in Business Intelligence through Data Mining,” we discussed how data mining is indispensible in helping today's executive discover hidden patterns of vital Business Intelligence (BI). With BI, LTC executives have been able to view their organizations’ financial, operational, and marketing Key Performance Indicators (KPIs) in real time. BI viewed through digital dashboards delivers the granularity, flexibility, and responsiveness executives need. Given the layers of information, or analytics, that is available through BI, managers can readily peer into their organization’s performance. Jim Hoey, President of Prime Care Technologies, recently reported, “Many of the executives I visit with understand the value that such a system can offer and have even taken advantage of its availability.”