If you bill for a skilled nursing facility (SNF), you need to submit bills consistently on time with zero errors. However, it’s easier said than done. That’s why having the Triple Check Process in your practice can help make clean claims a reality.
The Triple Check Process refers to the internal audit that promotes billing accuracy and compliance for regulatory guidelines before submitting those claims to Medicare/Managed Care providers for reimbursements. It is a three-layered approach that takes a collective effort from your Interdisciplinary Team (IDT) to provide Medicare/Managed Care residents with a check and balance of the entire admissions, billing, and Minimum Data Set (MDS) process. It needs to be completed around the eighth day of the month following the month you are closing.
Ensure all your Minimum Data Sets (MDSs) are completed, submitted, and accepted for the closing of the month before setting the specific date for your Triple Check meeting. Also, include your Business Office Manager, Administrator, MDS Coordinator, DON/Medical Records, and Rehabilitation/Therapy department.
Let your team review the following when conducting your Triple Check Process:
The Triple Check Process can seem overwhelming at times, but it also removes unnecessary hassles if/when an Additional Development Request (ADR) or insurance audit is requested. Here’s how you can prepare for your Triple Check under PDPM:
Before submitting to the Fiscal Intermediary, the practice is responsible for introducing an appropriate monthly triple-check procedure to ensure statements are correct. Each Medicare (Part A and B) claim before submission will be checked by the staff.
Responsible for ensuring that the meeting is held monthly and that everyone is present, on schedule, and prepared along with the Triple Check Checklist
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