Reimbursement

Ensuring you’re being appropriately reimbursed is an important part of continuing to provide quality care. Whether you are focused on PDPM, PDGM or other reimbursement policies, our team goes beyond what typical scrubbing software can provide by applying enhanced analytics and an eye for detail.

Areas of Support:

  • Patient Driven Payment Model (PDPM)

  • Patient Driven Groupings Model (PDGM)

  • Management reporting and analytics

  • Quality Management Consulting

  • I-SNP Consulting

  • Financial and operational strategies for Medicare, Managed Care and Case Mix

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Empowering Guidance

We offer many real-time solutions. We also offer training, guidance and support that is individualized and designed to empower you. With real-time interventions, you can get credit for the care you are providing, while you’re providing it.

On average, 30% of MDS assessments miss coding that would provide a more accurate description of resident characteristics and care needed. The result is that providers are not being appropriately reimbursed for the care they are providing.

30% of MDS assessments miss coding

PDPM Coding Consultation Process

When you decide to use PACS for PDPM Coding Consultation, we will focus on ensuring that you capture the unique conditions and characteristics of your residents’ care.

  • When your MDS coding is complete, send your reviewer an email with identifying information for the resident and any pertinent scanned documents that do not get stored in the EMR, such as hospital discharge paperwork.

  • Your PACS reviewer will promptly send you an email with coding recommendations, the rationale for the recommendations and the CMI impact.

  • You’ll also receive a Monthly Impact Report to show the overall results of your collaboration with PACS.

Achieve Results

We make sure you stay in the loop. For example, with PACS PDPM Coding Consultation, you’ll receive a Monthly Impact Report that shows your net reimbursement on a patient level. This detailed reporting illustrates how PACS strategies and coding recommendations are specifically impacting your bottom line. Additionally, you’ll receive a Monthly CMI Trend Report to show the overall impact of your collaboration with PACS.

  • More than 1/3 of the time (36%), PACS can earn you more money by ensuring your MDS accurately reflects your resident.

  • For those cases, taking our recommendations can increase your revenue by over $300 per audit.

  • On average, our customers realize over 150% ROI.