Triple Check
Who monitors the daily skilled documentation for skilled residents?
Who/What is the DNS or nursing designee.
What completed documents are to be scanned weekly to Tammy and Dana for review?
What are UR and CMI meeting forms.
When are CSC forms given to the BOM for Month End Close?
What is the last business day, no later than the 1st business day of the month.
What two items are needed to support a Nursing HIPPS of Special Care low for Cerebral Palsy with a GG Function Score of 8?
What are 60 days dx signed MD orders and active dx in the 7 day lookback.
This regulation (F tag) requires each resident be informed of when they become eligible for Medicaid and what items and services are not included in nursing facility services for which the resident may be charged.
What is F582
Who approves delays in the Triple Check process past the 5th business day of the month?
Who/What is the VPO.
What meeting is held weekly with IDT reviewing clinical conditions, Certs, last MD visit dates, Medicare days remaining, and plans for discharge?
What is the UR/PDPM meeting.
Is the CSC form used for benefit exhaust or benefit cuts?
What is benefit exhaust ONLY
Who alerts the IDT of billing changes during the CMI meeting?
Who is the BOM.
This regulation (F tag) requires nursing homes to develop and implement policies and procedures to ensure residents and staff receive education about the COVID 19 vaccine and that vaccines are offered to all who choose to be immunized.
What is F887
If a resident has multiple claims what questions may be skipped on each form?
What is NONE!
What assessment changes the payment for Traditional Medicare A stays on the ARD.
What is a Interim Payment Assessment (IPA)
The system we use to determine who is responsible for payment procedures, outpatient surgeries, ambulance bills, etc?
What is SNF consolidated billing (SNFCB)
How far out does the CMI meeting look at residents ARD's?
What is two weeks.
This regulation (F tag) requires a facility to provide specialized services such as PT, OT, ST, and RT as required in the residents’ comprehensive plan of care.
What is F825
If the cert/re-cert form is not completed or not signed by the MD/ARNP what happens with the claim?
What is the claim is held.
This person keeps a 3 month rolling calendar for planned DC's in an attempt to control the number of discharges on a given shift, day, and week.
Who is the Social Worker SSD
When does the DON give the list of flu/pneumonia injections being billed to the BOM?
Upon administration of the injection.
How often is the CMI meeting held in each facility?
What is at least weekly.
This regulation (F tag) requires a facility to ensure each resident receives education on flu and pneumonia vaccines and offers the vaccine for those that elect to receive one or both.
What is F883
When are claims created for Triple Check? And Why?
What is as soon as your therapy files are imported. So MDS and Therapy can review prior to Triple Check.
Who reviews for daily skilled charting during the UR/PDPM meeting?
Who is the DNS or designee.
Who signs the Triple Check verification forms?
Who/What are the ED, MDS, MR, BOM, Therapy, DNS/designee.
What is the purpose of the CMI meeting?
What is managing the health care benefits of each resident to ensure optimization and furthermore, to ensure that the facility is reimbursed for care and services provided.
This regulation (F tag) requires a facility to display written information, and provide resident with oral and written information, on how to apply for and use Medicare and Medicaid benefits.
What is F579