The Triple Check Process for Medicare Billing

Event Information
Product Format
Prerecorded Event
Presenter(s)
Marilyn Mines, RN, BC, RAC-CT
Length
60 minutes
Product Description

Learn How to Implement and Maintain Monthly Triple Checks


The Center for Medicare & Medicaid Services requires nursing homes to maintain and submit the Minimum Data Set (MDS) in their clinical assessment of all residents in Medicare and Medicaid certified nursing homes. Providing a comprehensive assessment of each resident’s functional capabilities in order to help nursing home staff identify health problems, MDS assessments are required for residents on admission to the nursing facility, periodically and on discharge, according to CMS.

In order to ensure accurate reimbursement and to meet CMS’s required quality measures, it is of utmost importance that facilities audit their own MDS records before submitting them. The triple check process is a mechanism to determine the accuracy and compliance of Medicare billing before it is submitted for payment. By comparing all the critical elements to documentation in a triple check, facilities can rest assured their claims will go through without a hitch. This proactive method also ensures that all information is accurate prior to submitting the UB04 form to the Medicare program for payment. A key benefit of the triple check is that you can identify what may be missing in order to prepare the clinical record for the possibility of an audit by one of the many contractors that CMS hires.

In this session with expert speaker Marilyn Mines, you will learn exactly how conducting the triple check will help prevent problems with auditors from RAC, MAC, ZPIC or the OIG. By conducting this check, facilities can see potential areas of concern vanish, identify necessary changes in processes and the need for education, and fully understand their residents’ clinical records.

Marilyn will show you how to implement and maintain monthly triple checks. Let her help your staff learn how to identify any necessary changes to your facility’s policies and procedures before any auditors show up to do it for you.

Session Highlights

  • How to conduct a triple check
  • Who should be included in the process
  • Which claims and how many should be reviewed each month
  • What is to be reviewed
  • What findings should be “corrected” or “self-reported”

Session Agenda

  • A proactive approach to accurate billing
  • Methodology
  • Gathering the triple check tèam
  • Selecting claims
  • Future samples
  • Reviewing claims
  • When to review documentation
  • Reviewing before billing
    • Therapy services
  • Findings and response
  • Ongoing monitoring
  • Management oversite

Who Should Attend

  • Therapists
  • Billing office personnel
  • MDS coordinator
  • Administrator
  • Special services (wound care nurse)
  • Clinical representation other than the MDS coordinator

Order Below or Call 1-866-458-2965 Today

You can also order through:

1-866-458-2965

1-800-508-2592

About Our Speaker

Marilyn Mines - Skilled Nursing Coding  Expert

Marilyn Mines RN, BC, RAC-CT, brings over 40 years of experience as a practicing Registered Nurse to her role as Director of Clinical Services for FR&R. While working with clients, she has been instrumental in preparations for JCAHO, Public Health and Public Aid inspections, and promoting confidence in the direct care of patients, as well as managerial staff.


As an educator and advisor, Marilyn...   More Info
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