Post-implementation services

Skilled nursing facilities have worked diligently to prepare for the implementation of the Patient Driven Payment Model (PDPM) and continue to work to ensure that what they have developed and implemented is effective, efficient and results in accurate reimbursement. Now that PDPM is in effect, are you confident that your organization’s systems and processes achieve accuracy and support for the PDPM reimbursement system?

Prepare for a potential audit

Will your organization meet the requirements and scrutiny of a Centers for Medicare and Medicaid Services’ (CMS) audit?

At Baker Tilly, our clinical specialists can serve as an independent third party to perform an external evaluation of your systems and processes. Whether you are an existing or new client, we take an objective approach to the evaluation process and pride ourselves on our integrity during the examination. Your team will benefit from the practical approach that we leverage to communicate recommendations and to educate your team.

PDPM advisory services

Our team can assist your organization with many aspects of PDPM, including:

  • Reviewing the medical record documentation support for the nursing component of PDPM
  • Validating the admission and other clinical conditions for the non-therapy ancillary (NTA) component
  • Evaluating items that result in the three rehabilitation therapy components
  • Assessing compliance with Medicare technical eligibility criteria
  • Validating documentation is supportive of the Health Insurance Prospective Payment System (HIPPS) codes billed to Medicare
  • Reviewing systems and processes implemented to support PDPM
  • Providing recommendations, and/or education for team members, on areas that have been identified as needing an increased level of reimbursement accuracy and support

Our team can assist your organization with many aspects of PDPM, including:

  • Reviewing the medical record documentation support for the nursing component of PDPM
  • Validating the admission and other clinical conditions for the non-therapy ancillary (NTA) component
  • Evaluating items that result in the three rehabilitation therapy components
  • Assessing compliance with Medicare technical eligibility criteria
  • Validating documentation is supportive of the Health Insurance Prospective Payment System (HIPPS) codes billed to Medicare
  • Reviewing systems and processes implemented to support PDPM
  • Providing recommendations, and/or education for team members, on areas that have been identified as needing an increased level of reimbursement accuracy and support