Blog: CMS 5-Claim Reviews – Lessons Learned
Susan Krall
January 11, 2024
CMS kicked off their 5-claim SNF audits June 5th, 2023. Audits are PDPM claim focused, dating back to October 2019
CMS kicked off their 5-claim SNF audits June 5th, 2023. Audits are PDPM claim focused, dating back to October 2019
Self-identification of errors in billing or documentation is a powerful tool toward minimizing medical review risk. Recognizing and correcting deficient
On 5/4/23, CMS alerted providers of a 5-claim PDPM probe review to be conducted by Medicare Administrative Contractors (MACs) for
Lack of substantiation of MDS Section GG is frequently a citation among medical review findings, especially from Managed Care audit
To many, the multiple contractor requests that comprise the world of medical review are simply summarized as “ADRs” – for
CMS kicked off their 5-claim SNF audits June 5th, 2023. Audits are PDPM claim focused, dating back to October 2019
Self-identification of errors in billing or documentation is a powerful tool toward minimizing medical review risk. Recognizing and correcting deficient
On 5/4/23, CMS alerted providers of a 5-claim PDPM probe review to be conducted by Medicare Administrative Contractors (MACs) for
Lack of substantiation of MDS Section GG is frequently a citation among medical review findings, especially from Managed Care audit
To many, the multiple contractor requests that comprise the world of medical review are simply summarized as “ADRs” – for
