1. experience momentum // CPAs & ADVISORS UNDERSTANDING THE FINANCIAL LINKS BETWEEN CLINICAL AND BILLING Sherri Robbins/Julie Bilyeu

2. UNDERSTANDING THE FINANCIAL LINKS BETWEEN CLINICAL & BILLING Clinical Billing 2 // experience momentum

3. PAYMENT STARTS AT ADMISSION Pre-Admission ScreeningDefined Process/Checklist Scanning Key Documents into Software Authorization Tracking

4. DETERMINING COST OF CARE 4 // experience momentum

5. CONSOLIDATED BILLING Inclusions/Exclusions Major Category Exclusions Statutory Exclusions Place of Service Impact Provider Responsibilities Negotiating Contracts Timely Payment Notice of Skilled Stay CMS Resources Major Category Explanation HCPCS File Fee Schedules/Rates

6. TECHNOLOGY 6 // experience momentum

7. 7 SNF Performance 30 Days Medicare Medicaid Private 60 Days Insurance 90 Days Coinsurance

8. A/R MANAGEMENT Monthly A/R Meetings Knowledge Billing and Software Rate Changes Payer Variances Contractual Adjustments Bad Debt Write Offs Sequential Billing 8 // experience clarity

9. INCREASED PAYER SCUTINY ADR RAC ZPIC 9 // experience momentum

10. DOCUMENTATION RISK AREAS ADL Prior Level of Functioning Isolation Daily Skilled Need Therapy Medical Necessity 10 // experience momentum

11. CLINICAL OVERSIGHT RUG Distribution ADL Distribution Average length of stay Length of stay by condition/diagnosis PEPPER Quality Indicators Quality Measures Staffing

12. MANAGING SKILLED CARE-OVERSIGHT Don’t miss the boat on skilling residents for skilled nursing

13. UNSCHEDULED ASSESSMENTS Change of Therapy End of Therapy End of Therapy- Resumption Start of Therapy Short Stay

14. EARLY/LATE/MISSED ASSESSMENTS Early Bill Default for # days out of compliance Late Bill Default for # days out of compliance Missed Bill Provider Liability

15. 15 // experience clarity

16. TRIPLE CHECK Patient Demographic Info Admission and Physician Documentation General Claims Data Specific Billing Codes MDS Data Ancillary Charges Discharge Information

17. COMMUNICATION IS KEY Daily Nursing & Therapy Communication Weekly Medicare Meetings Monthly Triple Check

18. ICD-10 Effective 10/1/2015 services Practice dual coding now!! Invest in coding resources PLANPRACTICEPREPARE 18 // experience momentum

19. BKD THOUGHTWARE Subscribe for Free http://pages.bkd.com/SubscriptionManagement_Center.html 19 // experience momentum

20. THANK YOU FOR MORE INFORMATION // For a complete list of our offices and subsidiaries, visit bkd.com or contact: Sherri Robbins, RN // Senior Managing Consultant slrobbins@bkd.com // 417.865.8701 Julie Bilyeu //Director jbilyeu@bkd.com // 417.865.8701