Complex Contracts
Multiple contracts. Different rules. Limitations. Exclusions.
Online contract data and case management workflows to maximize your revenue.
Multiple contracts. Different rules. Limitations. Exclusions.
Tracking dates, authorizations, appeals. Concurrent patient updates.
Pinpointing where the loss of revenue is happening.
Learn how managed care MASTER can help optimize your revenue by guiding your case management based on contract terms.
Convert paper and binders into convenient online access. managed care MASTER breaks your complex contracts down into measurable pieces, integrating your resident population with payers and contractual limitations.
Best practices in case management are built into this app to guide staff in properly managing skilled care stays. Say goodbye to paper; complete patient updates in real-time, as a team.
"With web-based data at our fingertips, we process updates during our morning meetings, which can save us up to 30 minutes per update."
Acting as an automated gatekeeper, our system provides calls-to-action for your staff and delivers actionable steps for resolution.
"Real-time alerts prompt case managers to request higher levels of care. In most cases, we receive authorizations for increased levels, which help our revenue."
Our update process is so much quicker and easier. We no longer pass paper updates from department to department. Or, send endless reminder emails and handwritten updates to external case managers.
In the PDPM, there are 5 case-mix adjusted elements: Nursing, Occupational Therapy (OT), Physical Therapy (PT), Non-Therapy Ancillary (NTA), and Speech-Language Pathology (SLP). Each resident is to be categorized into one and only one group for each of the 5 case-mix adjusted elements.
Under the Patient Driven Payment Model, there are a greater number of valid HIPPS codes compared to RUG-IV. Note that there are many fewer assessment signs under the PDPM. PDPM has 25 Nursing case-mix groups, 16 PT/OT case-mix groups, 6 NTA case-mix groups, and 12 SLP case-mix groups, which increases to 28,800 combinations.
Providers will bill for services under PDPM utilizing the Health Insurance Prospective Payment System (HIPPS) code that is created from evaluations with an Assessment Reference Date on or after October 1, 2019. The HIPPS code under PDPM remains a 5 character code, as in RUG-IV.