Life as a Clinical Reimbursement manager

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We often are focused on the frontline staff that we may have not noticed the changing roles of your management staff.

What has changed for your managers ?

Your Manager could be at the center level who is responsible for the reimbursement team reaching goals.

They may be in a regional role and are responsible for outcomes of several facilities that may not have key personel in the positions needed to be successful.

How can you be successful in your role during these challenging times?

You may want to have a weekly visit or call with your reimbursement MDS/MMQ staff to assess the needs of your facility/facilities.

Encourage open communication for all staff and encourage them to share any barriers they are having at the center level.

Schedule a monthly open office meeting with all the facilities you monitor to have a place that all centers can have an open discussion on what’s working to help them meet the tasks of their roles.

Prioritize any of your facilities that may have critical open positions and assess if there is any staff in the facility that can fill in the role.

Cross train staff to be able to cover all roles on the reimbursement team.

Continue to educate yourself re: reimbursement regulation changes.

Changes are coming to the tool that is utilized in Long term care for reimbursement : Please see link below.

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual

What’s New –

December 23, 2022

NOW AVAILABLE: Draft MDS 3.0 Item Sets v1.18.11

The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. CMS plans to release the final version of the MDS Item Sets in early 2023.  The MDS Item Sets v1.18.11 will be effective beginning October 1, 2023.

These changes have most managers anticipating increased challenges for the reimbursement team. There will be increased educational needs that may hinder assessments being completed on time. Attempt to plan time for staff to learn the upcoming changes that does not coincide with scheduled time that they are expected to be completing MDS assessments as well.

The most important lesson to remember as you continue in your management role is to attempt to have a work life balance. Remember to take time for yourself as well. Managers are often so busy attempting to ensure the staff in their charge are taken care of that they may overlook self care.

I encourage you to share with your colleagues what has helped you be a successful Manager.

Please reach out to Skilled Nursing Support if you or your team is in need of education re: reimbursement functions or support in for MDS/MMQ tasks.

DEC 2022/SKilled Nursing Support/maria.messina@skillednursingsupport.com

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