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2021 Audit Forecast: Cloudy with a Chance of Storms

by Proactive Medical Review | Apr 21, 2021 | Audits, Compliance, Legal, Medicaid, Medical Review, Medicare

Following a year of little to no medical review and extensive government spending, most experts forecast reimbursement compliance audits ramping up in 2021. Multiple areas are ripe for potential scrutiny, including, but not limited to PDPM coding and supportive...

Taking Your Nursing Documentation to Court

by Proactive Medical Review | Mar 15, 2021 | blog, Documentation, Legal, Medicaid, Medical Review, Medicare

“No matter how skilled or experienced you are, inaccurate or incomplete nursing documentation can mean serious trouble for your patients – and for you if you’re ever involved in a lawsuit.” Austin, Nursing2021. Many nurses who have had to testify in a deposition or...

Medicaid Case Mix Index (CMI): Common Errors & Opportunities

by Proactive Medical Review | Jun 10, 2020 | blog, CMI, Education, Medicaid, Reimbursement

Case mix index (CMI) is the metric by which the relative cost of treating residents covered by Medicaid is measured.  It also sheds light on the type of residents being treated and the burden of care required.  Because the primary payer source for most facilities is...

Q & A – What is an advance payment and how do I apply for one?

by Proactive Medical Review | Apr 1, 2020 | blog, COVID-19, Education, Medicaid, Reimbursement

Q: What is an advance payment and how do I apply for one? A: An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims submission and/or claims processing. These expedited payments can be offered in...

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Proactive Medical Review Consulting, LLC

2207 Morgan Ave, Suite D
Evansville, IN 47711

Phone: (812) 471-7777
Fax: (812) 471-7802
info@proactivemedicalreview.com