October 12, 2018
Volume II, Issue 7
In this edition:
-Breaking News
-Money Matters
-Coming Down the Pike
-New Medicaid Card: MBI
on Remittance Advice
October 1
-ACT Senior Living
Consulting Services

Spotlight
ACT welcomes three new Health Care Service Consultants:

Rose Sayre is a part-time Skilled Nursing Facility Billing Consultant. Rose has nearly eighteen years of experience in the health care industry and joins the Charleston, WV team.

Melissa Snyder is a Clinical Consultant. Missy is an LPN with over twenty years of experience. Missy will work in our New Castle, PA office.

Richard Snyder is a Health Care Consulting Billing and Reimbursement Consultant. Rick has over twenty years of long-term care billing and reimbursement experience and will work in our New Castle, PA office.

The ACT Executive Committee recently developed enhanced principles. Our new Vision Statement declares ACT is, "A strategic resource making a positive difference in the lives of our team members, clients, and community."

For more information about our Vision, Mission, or Culture, read about Our Principles on our website.
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Charleston
304.346.0441 | 800.642.3601
Bridgeport
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304.472.5550 | 800.924.0729
Morgantown
304.225.6000 | 866.624.5471

PENNSYLVANIA
New Castle
724.658.1565 | 800.452.3003
Pittsburgh
412.635.6270 | 800.452.3003
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814.336.2133 | 800.452.3003

OHIO
Columbus
614.223.9209 | 800.642.3601
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Breaking News
Several sources have recently reported on the “record low” occupancy in the skilled nursing facility (SNF) sector. Where is the former SNF population going? One factor influencing that change is the advance in clinically sound post-acute care pathways offered by providers in other settings. Home Health Agencies (HHA) have increased their caseload by offering programs that are more cohesive, collaborative, and advanced in nature than ever before. This includes the ability to offer remote monitoring of core indicators that flag when provider intervention is necessary.

Other post-acute services are thriving with the growth of home-based physician/extender services and increasingly available home care services. These unskilled services provided in the home, whether it is a house, condominium, apartment, or other “home” setting, may not provide clinical support; but they can play a pivotal role in keeping the aged and disabled safe. The main causes of hospitalization include medication mismanagement, hydration and nutritional issues, and a lack of social support - all issues that can be addressed by someone who visits regularly.

This increase in availability, along with the trend to move toward non-traditional Medicare Advantage plans that promote community based services, are the major influencers in the decline in SNF census.  Information detailing actual census number varies by source, but the message remains the same. The shift in health care delivery options continues.  

Money Matters
The Centers for Medicare and Medicaid Services (CMS) Skilled Nursing Facility Patient Driven Payment Model (PDPM) is slated to go into effect in one year. The method SNFs will be reimbursed for Medicare patients is significant. What can you do now to help prepare? Assess documentation and care systems and determine which elements need to be addressed or changed, provide advanced clinical training, and begin staff education. Organizations, both large and small, will need to have “experts” in-house or on-hand to help lead the charge.  Step one: Identify the individual who will serve as the expert and help them get started down the right path.  

Coming Down the Pike
The Flu! The Centers for Disease Control (CDC) has sent out reminders that EVERYONE six (6) months and older who does not have a severe allergy to the flu vaccine should be vaccinated by the end of October. Advances in the vaccine have led to the availability of three different options. Options include Inactivated Influenza Vaccine (IIV) for individuals six months and older, Recombinant Influenza Vaccine (RIV4) for individuals who are 18 and older, and Live Attenuated Influenza Vaccine (LAIV4) for individuals who are 65 and older. Individuals who are allergic to the flu vaccine, eggs, have had Guillain-Barre Syndrome (GBS), or are currently acutely ill should talk to their physician to identify the best option.

New Medicare Card:
MBI on Remittance Advice October 1
For Remittance Advices generated after October 1 through the end of the transition period , the CMS will return both the new Medicare Beneficiary Identifier (MBI) and Health Insurance Claim Number (HICN) when a claim is submitted with a valid and active HICN. The new MBI is reported in the same place as the changed HICN effective immediately. Patients’ new Medicare cards include their MBI or MBIs can be accessed via the Medicare Administrative Contractor’s look up tool through their portal .
 
To ensure Medicare patients continue to receive care, use either the HICN or MBI for all Medicare transactions through December 31, 2019. 

ACT Senior Living Consulting Services
ACT can help you address census concerns by assessing your market, identifying opportunities to grow your customer base, help develop short and long-term plans to achieve the changes needed to reposition your business in the market, and provide guidance and education to key staff members.  Contact us to discuss your support needs and opportunities.


Stay up-to-date with important news by accessing this newsletter and more in the Knowledge Center on our ACT website!