medicare pps report tutorial...14 medicare pps report: introduction (cont.) section 1: choose your...
TRANSCRIPT
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Medicare PPS Report
Self‐Guided Tutorial
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Tutorial Objectives
After completing this tutorial, you will be able to:• Identify the purpose of the Medicare PPS Report
• Access the Medicare PPS Report• Customize the Medicare PPS Report
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Overview: About the Report
PointRight’s Medicare PPS Report:– Displays the assignment of Medicare assessments into RUG categories
– Presents changes and trends in facility Medicare program over time using categories and criteria from the RUG‐IV grouper
– Approximates number of resident days for each RUG group.
• PointRight analysis is a close approximation to the actual number of resident days for each RUG group; a more accurate analysis is not possible without analyzing your facility’s UB04 records
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Access the PPS Report
• The following slides will guide you through the steps to access the Medicare PPS Report
– Step One: Login to PointRight
– Step Two: Select the Report you want to see
– Step Three: Review the Report
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Step One: Login to PointRight
1. Go to:
www.pointright.com 2. Click Client Login
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Step One: Login to PointRight (cont.) 3. Click the MDS Submissions & Reports link
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4. Enter your Log In information
User Name Password
The password is case sensitive!
5. Click Log In.
Step One: Login to PointRight (cont.)
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Step Two: Access the Medicare PPS Report
Roll the mouse icon over the Products tab.The Products drop‐down menu displays.
In the Products drop‐down menu, click Medicare PPS Reports.
1. Roll over the Products tab.
2. Click Medicare PPS Reports.
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Step Two: Access the Medicare PPS Report (cont.)If you have access to multiple facilities, you can also click the facility name whosereports you want to see.
1. Left‐click on the name of the facility whose information you want to see. The drop‐down menu displays.
2. Click “Products” from the drop‐down menu to go to the Products page.
2. Click “Products”
1. Click the facility name
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Step Two: Access the Medicare PPS Report (cont.)
From the Products page, click the Medicare PPS Reports.
3. Click Medicare PPS Reports
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Medicare PPS
Facility Reimbursement Report
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The Medicare PPS Report
The Medicare PPS Report includes: • Introduction• Medicare Days• Medicare Trend• Rehabilitation• Estimated Medicare
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Medicare PPS Report: IntroductionThe Introduction page of the Medicare PPS report contains three sections:
1. Report customization options‐ Select Report Period ‐ Select Rate
2. Information display‐ Select a Tab to display the information you want to review
3. Wage Index Table‐ Displays Wage Index information for the State and County
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Medicare PPS Report: Introduction (cont.) Section 1: Choose your Report customization options, then click the “Update” button.
Select the Report Period from the dropdown menu
Select the Medicare Rate
* Note:The Report Rate defaults to “Local” which automatically applies the local rate based your facility’s address.
If you prefer, choose one of the Federal Rates by clicking the radio button next to that rate.
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Medicare PPS Report: Introduction (cont.)
The top paragraph of the Introduction summarizes the Medicare assessments and Rates used for the selected time period.
Paragraph (1) explains payment rates used in the report calculation.
Paragraph (2) summarizes the percent of assessments for which the number of Resident Days needed to be estimated.
Paragraph (3) explains that the is dependent on the assessments that are submitted to PointRight.
Section 2: Information DisplayClick a Category Tab to see information and
Reports related to that category.
The Introduction Tab is the default.
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Medicare PPS Report: Introduction (cont.)
Section 3: The Wage Index Table displays the changes in your facility’s Local Wage Index over time. Information includes the Fiscal Year Start Date, and the facility’s designated Urban/Rural status.
This information is updated by PointRight for each Fiscal Year.
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Medicare PPS Report
Medicare Days
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Medicare PPS Report: Medicare Days
Report Generation Date
The Medicare Days Report provides a detailed overview of Medicare Resident days.Click the “Medicare Days” Report tab to view the Report.
Two Report view options:• By Category• By Category and
Assessment Type
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Medicare Days: By Category
Click each section of the pie chart to drill down to Resident details.
Key features of this Report include:
‐ Text summary of the percent of billable days in the Rehabilitation RUG category
‐ Overview of the percentage of resident days for the selected month in each RUG category. Percentages are also displayed in the Legend next to the pie chart.
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Medicare Days: By Category and Assessment Type
Key features of this Report include:
Display of resident payment days by RUG category and MDS assessment type.
You can click each section of the bar chart to drill down to resident details.
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Medicare PPS Report
Medicare Trend
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Medicare PPS Report: Medicare Trend
Key Features of this Report include:
View and compare all assessments in the same bar graph, or click the desired tab to view a specific assessment type.
Data displays for all assessments in each category for the past 24 months.
You can click each section of the chart to drill down to resident details.
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Medicare PPS Report: Medicare Trend (cont.)
Medicare Trend graphs can be customized by:Y‐Axis ‐ Select the measurement to display on the Y‐Axis.Graph Type – Select the graph type.
Click the “Update” button to view the graph with the new selections.
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Medicare PPS Report: Resident Drilldown
Resident Drilldown page
This page displays all the residents in the category you clicked on in the chart or graph.
Medicare billed days are shown for the month listed in the chart title.
Click a resident’s name to view their complete MDS history, including all the Medicare days regardless of the month selected.
Click an ARD to review a copy of the MDS.
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Medicare PPS Report: Resident Drilldown (cont.)
This is an example of resident MDS history detail.
Click the ARD to review a copy of the MDS.
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Medicare PPS Report: Medicare Trend (cont.)
You can track your facility’s Change of Therapy OMRAs using the OMRA COT tab.
Click the bar to see complete details
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Medicare PPS Report
Rehabilitation Tab
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Medicare PPS Report: Rehabilitation
The Rehabilitation Reportincludes two parts:
The Summary tab displays a summary of Rehabilitation assessments for the selected time period
The Required ADL and Therapy Minutes tab displays the qualifying criteria for the Rehab RUGS
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Medicare PPS Report: Rehabilitation SummaryThe Summary graph displays all the Rehab and Rehab +Extensive RUG groups in reference to the ADL index of the MDS.
Use this graph to check your ADL accuracy and make sure you are capturing the appropriate RUG for each Resident.
Blue indicates ADL index one pointaway from the next lower RUG.
Red indicates ADL index in the middle for this RUG.
Green indicates ADL index one pointaway from the next higher RUG.
Y‐Axis options can be customized to display Resident Days or Assessment Counts.
Click to see details
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Medicare PPS Report: Rehabilitation Criteria
Example: For the RMC category, an ADL index of 11‐ 16, and at least 150 minutes of provided therapy are required.
The Required ADL and Therapy Minutes tab displays the qualifying criteria for the rehab RUGS (provided as a resource only).
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Medicare PPS Report
Estimated Reimbursement
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Medicare PPS Report: Estimated Medicare Reimbursement
The Estimated Medicare Report displays estimated Reimbursement and Per Diem.
Report is updated in real time with new MDS submissions.
Reimbursement Tabs:
By RUG (displays by group)• Report explanation is at the top of the page •The Table displays estimated reimbursement for the month by RUG group
By Category (displays by category)• Report explanation is at the top of the page •The Table displays estimated reimbursement for the month by category
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Medicare PPS Report: Estimated Medicare Revenue and Per Diem
The Revenue and Per Diem report displays the changes in Medicare reimbursement over time.
The graph displays a 24 month trend comparing the total estimated reimbursement (blue line) and the estimated average per diem rate in dollars, by month (red line).
Estimated Medicare dollars display on the left axis. Estimated Per Diem dollars display on the right axis.
Roll your mouse over a point on the graph to see a popup with details.
Click a point on the graph to view resident details for every resident assessment with payment days during that month.
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Printing Medicare PPS1. Roll the mouse icon over the Print tab, and select Print Report from
this Page2. View Medicare PPS as a printable report
3. Click the Print button in the report window to print.
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Tips for Success• Review RUG distribution in the pie chart and bar chart to determine
staffing needs and assign resources– Insight into Medicare RUG distribution assists the IDT in RUG
prediction and control• Apply reports to your Medicare compliance program
– Drill down to identify potential issues with Therapy and ADL coding– Individual, concurrent and group minutes are easily audited
• Use the Medicare Trend to track changes in the Medicare caseload– Look at SOT/EOT OMRA and COT OMRAs to ensure expected RUG
changes occur• Helps prevent file rejections
• Review Medicare reimbursement in real‐time• Use the Estimated Medicare table to compare your facility’s 12
month history of RUG days to the current month’s performance
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Need Help?Use the Ask a Question page to submit a question to our online Help Desk.
2. Type your question in the text box and click the “Submit” button.
Type your question here.
1. Select “Ask a Question” from the Help menu.
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Contact Us!
PointRight Inc.420 Bedford Street, Suite 210
Lexington, MA 02420www.PointRight.com
(781) 457‐5900 (phone)(781) 674‐2254 (fax)
To speak with Client Services select ‘Option 1’, then ‘Option 2’ ‐or‐
email: [email protected]