Reimbursement

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...

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,...

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...

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,...

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...

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...

In compliance with the Centers for Medicare & Medicaid Services (CMS) Medicaid Managed Care Final Rule 2390F and 42 CFR 438.602(b)(1), all KanCare managed care organization (MCO) network providers who receive payment for KanCare...

The latest 5 Star Reports were emailed out to members last week. This contains the latest analysis for your organization. Last week’s AU article regarding the Medicaid Rate Incentives contained a link to the 5...

Have you been considering purchasing Quality Apex, but still want more information? On the Quality Apex marketing website you will see a section that has been added to register for webinars. (www.qualityapex.com) These will...

LeadingAge Kansas personnel, along with representatives from KHCA and KACE, met with KDHE personnel recently regarding the Clearinghouse. We shared concerns with KDHE, gathered from members, regarding the inaccuracy of Patient Liabilities, continued communication...