The financial health of your skilled nursing facility (SNF) depends on claims that are sent on time and accurately. If you’re in the SNF business, you understand the complex process of submitting claims and getting properly paid. The success of reimbursement depends on countless tasks going off without a hitch and in the right order. And if even one task goes wrong, it leads to big problems.
The SNF triple check review helps your facility ensure billing accuracy and compliance with regulations before you submit claims to Medicare or managed care providers. The triple check review is an internal tool to align your entire billing and clinical process to ensure you get paid accurately, quickly, and lessen the chance of Medicare scrutiny.
When to perform a Triple Check Review
Since SNFs operate differently, some pick one day a month to perform the review, such as early in the month after closing the previous month. If you chose this route, be sure all the MDSs for the closing month are completed, submitted and accepted before you begin your review.
Other SNFs may prefer to implement the process throughout the month rather than have one meeting that tries to cover everything. This is a validating as you go method that will help your team get most of the work done prior to meetings so that meeting time is limited. Some SNFs prefer to have a weekly targeted meeting, with one wrap up meeting at the beginning of the month.
Who should participate?
Triple check reviews should be a team effort. Your billing manager, MDS coordinator, and someone from rehab/therapy should be integral members of the review. You may also consider including your administrator, Medicare Coordinator, Director of Nursing and a representative from medical records in the process.
Check out this special Triple Check Review list our SNF team created to help you succeed.