Reimbursement

The recent Medicaid rates included new incentives for providers. These resulted in many questions from providers regarding how the measures were calculated, especially the Quality Measures incentive. Myers & Stauffer has prepared a more detailed...

A revised SNF Consolidated Billing Web-Based Training course is available through the Learning Management System. Learn about: Skilled Nursing Facility (SNF) coverage and payment guidelines Bundled prospective payments Services excluded from SNF consolidated billing The...

Effective with payment denials processed on and after May 1, 2017, the three KanCare managed care organizations (MCOs) standardized the process for disputing a denial of payment by an MCO through submission of a Reconsideration, Appeal,...

Aetna Better Health of Kansas, Inc. will be a new KanCare MCO beginning January 1, 2019. Sunflower State Health Plan, Inc and United Healthcare, Midwest, Inc. will continue services for Kansas providers and members alike. Per...

LeadingAge Kansas personnel will be meeting with KDHE regarding updates on the Clearinghouse and Medicaid application processing. In preparation for this, our question to you is “How is it going?” We are looking for...

There are times when a Medicare Beneficiary Identifier (MBI) may change. People with Medicare or their authorized representatives can request an MBI change. CMS can also initiate a change to an MBI (for example,...

All facilities should have received notice of their July 1, 2018 Medicaid Rate through the Myers and Stauffer portal. These rates include rebasing with Cost Report data for 2015-2017 with partial inflation through 7/31/18....

New Medicare cards may have a square code, also referred to as a QR code (a type of machine-readable code). The QR codes on Medicare cards allow the contractor who prints the cards to ensure...

LeadingAge Kansas had a question from a member related to when PEAK ratings will be announced. Per Laci Cornelison at KSU PEAK 2.0 all of the homes being considered for levels 3-5 have received...

Phase Two of the SNF Value Based Purchasing (VBP) Review and Corrections process will begin in early August 2018 when annual performance score reports are made available in the Certification and Survey Provider Enhanced...

Long-Stay Hospitalization Quality Measure CMS continues to focus on reducing hospitalizations to improve the health and safety of nursing home residents. Hospitalizations are expensive, disruptive, and place residents at risk for an increased decline in...

Sunflower Health Plan will be hosting a Summer Provider Orientation Webinar on June 29th at 12:00 pm. This will be a quarterly new provider and refresher orientation. They will provide information on Sunflower’s processes...