PDPM CLAIM PROCESSING ISSUES RESOLUTION

The implementation of the Patient-Driven Payment Model (PDPM) seemed to go fairly smoothly, until providers started submitting claims. Claims were reported to be held or paid at the wrong rates. Claims with multiple HIPPS codes were not getting processed. The Centers for Medicare & Medicaid Services (CMS) has clarified how the payment issues are being addressed and when the PDPM claims will be processed and paid. Click here to access a summary of this information prepared by the American Health Care Association (AHCA).