PDPM Self Audit

Self-Audit your PDPM Payment Process

June 22, 2021

Part 6 of a 6-part series titled “Simple and Easy: Winning in PDPM Payment and Regulatory Strategies”

Presented By: Leah Klusch, RN, BSN, FACHCA, Founder and Director of The Alliance Training Center

Date: June 22, 2021 at 1:00PM E/ 12:00PM C

Part 6 of a 6-Part Series
Using internal data audits on active Part A Medicare cases is an excellent way Senior Managers and department heads can monitor MDS 3.0 data flow into the PDPM payment process. This session will describe a simple but effective process to audit data flow producing payment using HIPPS codes. All Medicare Part A stay assessments create a HIPPS code prior to transmission of the MDS. Simple steps to identify the HIPPS code and align the codes into the payment categories can identify payment and Data accuracy risks. This audit can be used to identify issues or confirm accuracy and compliance. Case studies and audit formats will be presented with specific discussion.

Key Webinar Learnings

  • Review the importance of conducting real time data accuracy and compliance audits.
  • Identify the definition and purpose of HIPPS code calculation in the MDS software program.
  • Identify the location and purpose of the HIPPS code in the Part A Medicare Assessment and billing process.
  • Describe the data summary and documentation process to organize the HIPPS code indicators into payment process groupings.
  • Discuss the HIPPS data summary and the use of data to identify documentation issues or confirm data accuracy.


Live Webinar Recording