1 min read

[May Webinars] PBJ and LTC Claims with SimpleLTC, PointRight and Pathway Health

By Prime Care Tech Marketing on Thu, May 12, 2016 @ 01:00 PM

In the next month, we'll team up with three long-term/post-acute care partners – SimpleLTC, PointRight and Pathway Health – to provide tips for the upcoming PBJ deadline from CMS and getting paid faster on LTC claims.

Register now for either of our PBJ sessions. Stay tuned to news for registration details for our claims session or check our events section early next week. 

Topics: LTC claims processing automation CMS pbj reporting
3 min read

Time to automate PBJ reporting to meet CMS' 3Q 2016 mandate

By Prime Care Tech Marketing on Tue, Mar 15, 2016 @ 05:00 PM


PBJ is just around the corner. So, what is it and what does it mean for you?

PBJ, or Payroll Based Journal describes what CMS requires you to submit online, effective 3Q 2016 and due 45 days after the quarter ends – that’s November 14.  From there, it will become a routine requirement for all SNF providers. And it comes with a kick in 2017 – a Five Star Rating kick. You are probably familiar with PBJ, but let’s net out the essentials so you can understand and act with some urgency. 

Background: With the passing of “The Improving Medicare Post-Acute Care Transformation Act,” or IMPACT Act, providers must submit “payroll and other verifiable and auditable data” electronically to the Department of Health and Human Services. It’s objective? Improve transparency and reduce potentially fraudulent reporting. You can check out the tedious details on the CMS and Federal Register websites:

The Change: In short, PBJ is the CMS’s latest push to keep providers honest when reporting labor hours and census – and eventually, will critically impact your 5 Star Rating.

  • Every quarter, providers must use the online PBJ system provided by CMS to report the hours staff – AND contractors – were paid to perform onsite services for facility residents, excluding paid time off (e.g., vacation, sick leave, etc.).
  • The PBJ system will only allow XML file submission – one per facility – and/or manual data entry at this time.
  • CMS started collecting staffing and census data through the PBJ system on a voluntary basis beginning on October 1, 2015.
  • Submission will be mandatory, effective July 1, 2016. Providers will be required to file both staffing and census data no later than 45 days after the last day of each fiscal quarter (i.e. for the quarter ended September 30, 2016 electronic reporting must be completed no later than 11:59 pm EST on November 14, 2016).

Don’t be lulled by the November 14 3rd quarter reporting deadline. Collecting this data and preparing it for submission will take time – lots of time (and money) – especially if you are trying to do this manually.

There is a way to make this PBJ requirement easier to swallow. We proactively added a PBJ tab to our primeVIEW business intelligence dashboard to help our clients. New clients can also purchase this component on a stand-alone basis to meet the CMS mandate.

Our PBJ Reporting Platform empowers providers to:

  • Integrate cross-facility data from employee and census systems
  • Manually enter and append contractor data to existing file
  • View/monitor a summary of employee and contractor hours
  • Automate mapping of labor codes to CMS codes
  • Export one all-inclusive XML file per facility for quarterly upload

With staffing and census playing a key role in the CMS’s Five Star rating and compliance, providers can’t afford to waste critical time building reports and checking data. An already-built solution quite simply frees up your time, so you can focus on proactive performance management.

The first mandatory reporting period, starting July, will be here before you know it. The time to act is now. 

And, if PBJ is the first major step you’ll take to aggregate all of the performance data you need to affect your Five-Star Quality Rating, check out our business intelligence blog

Topics: BI automation CMS PBJ Payroll Based Journal Centers for Medicare and Medicaid Services


Posts by Tag

See all