So, what are some strategies to ensure your success in the ADR/Denials process?
-Use a checklist to ensure all documentation is submitted to support billed services
-Ensure Physician’s Certification/Recertification is completed timely and in its entirety, and is included in documentation submitted for RAC audits
-When coding the MDS, be make sure to look for the two lookback periods to support Active Diagnoses:
-Educate on importance of daily skilled narrative documentation. Daily skilled nurse’s notes indicate skilled intervention which may consist of observing, assessing, educating, training, and managing the overall care of the beneficiary.
-Thorough documentation by the entire Interdisciplinary Team to demonstrate collaborative care to support HIPPS codes billed.
We strive to stay up to date on the latest trends and changes related to ADR’s & Denials. Please reach out to your Synergy Care contact with any questions you may have. We are here to assist you!
We are devoted in our commitment to providing education and updates to you as they become available. Thank you for your hard work and commitment through these ever-changing times.