Skilled Nursing Providers Losing Millions To Incorrect Data

During the LeadingAge Illinois Annual Meeting & Expo last week, two billing and reimbursement experts found that skilled nursing providers are losing millions of reimbursement dollars due to avoidable and costly billing errors.

Using data found during a cross-sectional study of long-term care providers between 2019 and 2020, it was discovered that 80% of these billing errors took place during the intake and admissions process due to incorrect information, such as the wrong health plan being entered into the billing system.

This means that skilled nursing providers are being put in a situation where they’re struggling to get paid for services they’ve already delivered, which is affecting their bottom line and even limiting patient care. Claim denials by Medicare Advantage plans averaged 8% to 10% per month. And though providers were able to get that down to roughly 4%, they usually let the rest go after several failed attempts to appeal the denials.

At BASE10, our compliance and regulatory expert Jaymie Wertz helps long-term care providers with federal and state disease reporting for the NHSN COVID-19 module. Find out how Jaymie and her team use BASE10’s software to automate the data entry and reporting process.

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How Vascular Conditions Are Associated With Dementia

A new study has found that people have a greater chance of getting dementia as they age if they have vascular conditions like heart disease, diabetes, or high blood pressure. For example, people over 55 years old who have diabetes were four times more likely to develop dementia.

The study, entitled “Determining Vascular Risk Factors for Dementia and Dementia Risk Prediction Across Mid’ to Later Life: The Framingham Heart Study,” appeared in the May 18 online issue of Neurology, the medical journal of the American Academy of Neurology.

Researchers also found that people over the age of 65 with cardiovascular disease were twice as likely to later develop dementia than their peers. Though if they were taking blood pressure medications to control vascular risk factors, then they had a reduced risk of getting dementia.

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Sign up and join us for BASE10’s upcoming webinar on Thursday, July 28th at 1PM CST: “Understanding Cardiovascular Disease Through a Different Lens with Precision Medicine.”

States Are Increasing Staffing Requirements in Nursing Homes

In response to COVID-19, minimum staffing requirements for nursing homes have changed in almost a dozen states. According to the Kaiser Family Foundation, their new analysis shows that five of those states have permanently increased their minimum staffing requirements, while Oregon and South Carolina have temporarily decreased their minimum staffing ratios to compensate for staffing shortages.

According to their data, the largest increase was adopted in Rhode Island where nursing homes went from a required 0.32 hours of direct care per resident, per-day pre-COVID to 4.1 hours per resident day. With the new requirements, providers have said compliance could cost an additional $325 million.

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Find out how BASE10 can help your facilities by learning more about BASE10’s disease management platform or contact us directly at sales@base10genetics.com. 

About BASE10 Genetics
Located in Chicago, BASE10 is a healthcare software technology company whose platform creates turnkey disease management programs that can be deployed at scale for nursing home operators, pharmacies, payors, and self-funded employers.