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Richter ShareSource Blog

Why Do I Need a Triple Check Process?

Posted by Jennifer Leatherbarrow on Aug 28, 2017 9:35:00 AM

When it comes to billing for your skilled nursing facility (SNF) services, you want your bills to be submitted with no errors and to be paid in a timely manner. In order for that to consistently happen, it is imperative that your facility complete a triple check prior to submitting claims. 

Triple check is an internal audit process to ensure billing accuracy and compliance with regulatory guidelines prior to submission of claims to Medicare/Managed Care Providers for review and payment. It is a multi-level process requiring a group effort of interdisciplinary team (IDT) members while providing a check and balance to the entire admissions process for new Medicare A/Managed Care residents.

For a free downloadable Triple Check Checklist for Medicare A, Medicare B, and Managed Care, click here.

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Topics: Clinical Consulting, Financial Consulting

Understanding RAI Manual Coding Updates and Avoiding Common Coding Errors

October 1, 2016 brought forth some significant changes to the Resident Assessment Instrument (RAI) Manual used by minimum data set (MDS) nurses throughout the country.

The RAI Manual is essentially an MDS nurse’s bible. It explains how to code and provides the rational for coding every single item on the MDS. If you have a question, it has the answer. My manual has never been far from me and the many notes and dog eared pages throughout it are a testament to that.

Today, the manual can be referenced online, so there is no need to carry the five inch binder around (although I still keep mine in the trunk of my car just in case). While the online version is a much better travel companion, I feel like we are not able to really dig our heels in and read it. For that reason, some items are much more likely to be miscoded in this new era of technology. Here are some of the most common areas I've found in which miscoding occurs:

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Topics: Regulatory Changes, Clinical Consulting

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