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222
PDPM Insights: Examining Accuracy through Targeted Auditing & Monitoring

With more than a year of the Patient Drive Payment Model (PDPM) behind us, we can now take a closer look at how MDS coding accuracy and supportive documentation have played a starring role in Medicare reimbursement. During this session, we will review common coding errors and supportive documentation vulnerabilities while focusing on essential auditing and monitoring considerations to promote accuracy and clean claims.   

  • Identify common coding errors and supportive documentation vulnerabilities related to PDPM reimbursement.
  • Define auditing and monitoring.
  • Implement effective auditing and monitoring practices through an Interdisciplinary approach to promote and ensure accuracy.

Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT, Clinical Consultant, Proactive Medical Review, English, IN
Eleisha Wilkes is a registered nurse and AANAC certified MDS consultant with more than twenty years of experience in long-term care. Wilkes specializes in MDS validation audits, Medicare and Medicaid reimbursement compliance, and competency-based staff education programs. She has presented extensively on the Patient Driven Payment Model and nursing facility readiness under the new reimbursement system.

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