CMS TO HOLD CLAIMS BEGINNING APRIL 1, 2021

BREAKING NEWS FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES

WHAT YOU NEED TO KNOW
Per CMS – In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, CMS has instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period of time.

  • This will not affect providers’ cash flow
  • It will minimize the volume of claims the MACs must reprocess if Congress extends the suspension
  • The MACs will automatically reprocess any claims paid with the reduction applied if necessary

Click HERE to read the announcement in its entirety on the CMS website.

Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported with compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Maria Maggi, Vice President of Quality, Outcomes, and Compliance at mmaggi@preftherapy.com.

KEPRO AND LIVANTA IMPORTANT REMINDER


BACKGROUND
The Quality Improvement Organization (QIO) goal is to complete appeals and quality of care reviews with healthcare providers as quickly and efficiently as possible.

As of October 2020, the Centers for Medicare & Medicaid Services (CMS) requires providers to send medical records for appeals and quality of care reviews to Kepro and Livanta electronically.

WHAT YOU NEED TO KNOW
This new procedure will allow the review process to be time-efficient and will help avoid any potential errors.

  • If you are unable to comply with the electronic submission, you must request a waiver from your QIO
  • Use your QIO’s online tool to send records
  • Refer to the medical request you received for detailed instructions
  • Record requests and submission instructions are emailed to your dedicated contact person
  • Be sure to update and verify this contact information via your QIO’s online form

Preferred Therapy Solutions continues to provide its partners with vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported with compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Barbara Blatt, Appeal Management Coordinator at bblatt@preftherapy.com.

The Preferred Therapy Solutions Family

It’s been a year – a year of new practices and procedures in how we work together. We are confident with science, research, and vaccines; we will again be able to work side-by-side seeing the smiles of our Preferred Therapy Solutions family. As we head into spring, we would like to share some of our pre-COVID-19 memorable moments of our smiling Preferred Therapy Solutions family.
#PreferredTherapySolutionsFamily #smilingfaces #wearefamily #itsallaboutthepatient #wearestrongertogether #PTSfamilyofcaring

NEW INTERNATIONAL DYSPHAGIA DIET STANDARDIZATION (IDDSI)

What’s your plan for rolling out the new IDDSI initiative? Preferred Therapy Solutions provides the necessary platforms in developing a crosswalk between IDDSI and Skilled Nursing Facility diets.

The Academy of Nutrition and Dietetics has announced that as of October 2021 IDDSI will be the ONLY texture-modified diet recognized by NCM (Nutrition Care Manual). The National Dysphagia Diet (NDD) and all available resources will no longer be included in the NCM. While participation is not “mandatory” at this time, dieticians and foodservice professionals may be impacted. Many hospital systems have transitioned to IDDSI or are in the process of doing so. Patient safety and a seamless transition of care will make education on the IDDSI diet levels paramount. 
The primary goal of the IDDSI committee is to standardize terminology and definitions of food and liquids for individuals with dysphagia across all ages and care settings. The IDDSI framework includes food and drink descriptors along with instructions for easy, reliable, and accessible methods to test different foods and drinks.  Contact Matt Nash mnash@preftherapy.com, to learn about Preferred Therapy Solutions clinical programs that are aligned with the new IDDSI standardization.
IDDSI FRAMEWORK

SOURCE: © The International Dysphagia Diet Standardisation Initiative 2019 @ https://iddsi.org/framework. Licensed under the CreativeCommons Attribution Sharealike 4.0 License https://creativecommons.org/licenses/by-sa/4.0/legalcode. Derivative works extending beyond language translation are NOT PERMITTED.