-Encore Rehabilitation’s monthly publication, designed to give you updates on trends we are seeing in the Post-Acute Care industry.-
ENCORE IS INVITING YOU TO WALK AROUND THE WORLD!!
Imagine all of the sights we will see during our travels as we log our combined steps and learn about new travel destinations along our journey. Places such as Colorado’s Rocky Mountains, California’s Disney Land theme park, the Hawaiian Islands, and Tokyo, Japan.
Participation in this event is easy. All that is required is for daily steps to be tracked and submitted to the Therapy Program Manager. As our journey Around the World advances, be sure to look for the company-wide weekly results posted on social media to see where our travel adventures take us.
Fun facts! Did you know that 2,000 steps = 1 mile? Or that 10,000 steps = 5 miles? Together we will circle the world in no time.
Let’s join together, put on our walking shoes, and begin this fun-filled Walk Around the World adventure!
ENCORE OFFERINGS 2022
- Regulatory Updates
- Impact on Business
- National Speaking Engagements
- Social Media
- Diversity & Inclusion Focus
- State Survey Preparedness
- Resident Satisfaction Surveys (RSS)
- Appeals Management
- Patient Safety – Risk Management
2021 IN REVIEW
With every twist and turn comes opportunity. Opportunity to learn, to grow, to think outside of our traditional approaches, and to look toward the future with continued optimism. At Encore, we have chosen to embrace the change, to utilize the talents of our employees to come together and create an even stronger and more forward-thinking and cohesive organization.
With gratitude, we thank all of those who have given themselves to caring for those individuals who needed exceptional care during these challenging times. Our patients continue to rely on us to not only help them achieve their goals for physical wellness, but to also incorporate an understanding of their mental wellness into our daily treatment approaches.
As we move through the coming year Encore has many innovative and exciting projects in the works that will benefit all aspects of our organization, our partners, and those patients we serve. Encore Rehabilitation Services is ready for whatever challenges come our way, and we look forward to being the foundation of strength and leader in innovation that our employees and partners can rely on as we move into 2022 and beyond.
Chief Executive Officer
President and Chief Operating Officer
PROTECTING MEDICARE AND AMERICAN FARMERS FROM SUQESTER CUTS ACT (S. 610)
- Provides a one-year increase (through December 31, 2022) in the Medicare Physician Fee Schedule of 3.0%, which reduces the overall conversion factor cut to .75% for CY 2022.
- Provides a three-month delay of the full 2% Medicare sequestration payment reduction (January 1, 2022 – March 31, 2022) and a three-month, 1% reduction in Medicare sequester payment reduction (April 1, 2022 – June 30, 2022), followed by implementation of the full 2% reduction to take effect July 1, 2022 – December 31, 2022. As a reminder, Medicare sequestration, a 2% payment reduction, applies across-the-board to all Medicare Programs, including Part A, Part B, and Medicare Advantage plans under Part C;
- Prevents the statutory Pay-As-You-Go (PAYGO) sequestration through 2022, mitigating an additional automatic across-the-board 4% cut to the Medicare program, among other programs.
Encore will continue to work with NASL, NARA, and our therapy professional organizations to advocate for the passing of Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act (H.R. 5536) which would provide for a temporary delay to a reimbursement reduction in the CY 2022 Medicare Physician Fee Schedule. The goal of the bill is to protect beneficiary access to therapy services by mitigating the impact of the impending Medicare 15% payment differential for services furnished by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) beginning on Jan. 1, 2022. Specifically, the bill would delay the implementation date of the Medicare 15% therapy assistant differential to January 1, 2023.
MIND, BODY, AND SPIRIT
TIPS TO AVOID RECOUPMENT
Many of the errors identified can be easily prevented or corrected. A routine internal review process can help to ensure common issues that result in denial of payment or recoupment are addressed before records are requested. The Encore Appeals Specialist assigned to the facility is also a resource to participate in reviewing the record prior to responding to audits, to address any potential issues and reduce the possibility of recoupment.
Some common denial reasons that result in payment takebacks are:
- Missing physician signatures on facility cert/recert forms.
- No date present with the physician signature for certs, therapy evals, and orders.
Incomplete certifications; the cert/recerts are required to include specific components that include but are not limited to:
- The reason for inpatient care
- Estimated time period that inpatient care is needed
- Plans for post-SNF care
Diagnosis coding on the MDS is not supported in the record.
- To code an Active Diagnosis in Section I, the condition must first be present on a physician-documented record within the last 60 days.
- Next, it must have a direct relationship to the resident’s current function, cognition, mood/behavior, medical treatments, nursing monitoring, or risk of death during the 7-day look back period (*except for UTI with 30 day lookback).
- Missing the deadline to respond to the requests or not responding to the request for records. Late or no submission will result in funds being recouped.