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Month: March 2018

Utilization: RN Visits Tick Up Under Payment Reform

  • By Sandy McCleve
  • March 30, 2018
  • No Comments

Social worker visits remain virtually unchanged under SIA policy. The jury is still out on whether Medicare’s hospice payment reform model implemented last year is fixing the benefit’s perceived problems, … Continue Reading →

Hospice: Rebounding Hospice Stats Underlie Rate Freeze Rec

  • By Sandy McCleve
  • March 29, 2018
  • No Comments

Number of providers climbed 4%. Although spring is here, hospices are still feeling the chill as the Medicare Payment Advisory Commission once again urges Congress to freeze their payment rates. Increases in … Continue Reading →

Payment: MedPAC Continues To Push Unified Post-Acute PPS

  • By Sandy McCleve
  • March 28, 2018
  • No Comments

Under PAC PPS, home health stays would see downward adjustment. While home care providers may have more pressing matters to deal with, they shouldn’t lose sight of the Medicare Payment Advisory … Continue Reading →

Know Your Facts: Number Of HHAs, Episodes Fell In 2016

  • By Sandy McCleve
  • March 27, 2018
  • No Comments

Drop in agencies occurred in fraud-prone areas, MedPAC says. Law- and policymakers are basing their decisions on facts and figures the Medicare Payment Advisory Commission provides in its annual report to Congress. … Continue Reading →

Reimbursement: MedPAC Report Urges Congress To Cut Home Health Pay By 5%

  • By Sandy McCleve
  • March 26, 2018
  • No Comments

Expect 14.4 percent profit margin for 2018. Home health agencies would see cuts on top of cuts, if Congress heeds an influential advisory body. As it voted in meetings earlier … Continue Reading →

Fraud & Abuse: Beware Bumped Up Penalties In Budget Law

  • By Sandy McCleve
  • March 23, 2018
  • No Comments

The Bipartisan Budget Act did more than change Medicare reimbursement. Get to know the substantial civil and criminal penalty updates for things as minor as improperly filed claims. Among the … Continue Reading →

Legislation: New Budget Law Axes ‘Super-MedPAC’ Board

  • By Sandy McCleve
  • March 22, 2018
  • No Comments

Option to pass the buck to appointed board now gone. While the created by the Affordable Care Act was never convened, many Medicare providers are glad to see it finally killed … Continue Reading →

Documentation: Tap These Resources To Help Make Your Claims Bulletproof

  • By Sandy McCleve
  • March 22, 2018
  • No Comments

Share tips and tools with your referring docs. You can boost your compliance — and reimbursement — by making sure your claims won’t fall prey to medical review denials based … Continue Reading →

Medical Review: Use These 8 Pointers To Defend Your Claims Against F2F & Cert Denials

  • By Sandy McCleve
  • March 22, 2018
  • No Comments

Will new F2F clinical template help you? Scrutiny of your claims is heavier than ever, and physician certification — including the face-to-face encounter — is a hot target for reviewers. … Continue Reading →

Medical Review: Don’t Be Surprised If RAC Review Is Around The Corner

  • By Sandy McCleve
  • March 22, 2018
  • No Comments

Monthly billing make hospice claims a tempting RAC target. Recovery Audit Contractor Performant has yet to name a specific audit topic related to hospice, but that doesn’t mean you shouldn’t worry about … Continue Reading →

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About Me

Sandy McCleve is the Managing Director at Advantage Healthcare Consulting with nearly a decade of experience as an accounting and tax preparation consultant specifically for healthcare providers.

Sandy has developed proprietary tools and systems that allow Advantage Healthcare Consulting to provide the fastest, most accurate cost reports and truly qualifies him as a specialist in Medicare and Medicaid Cost Reporting for Home Health Care Agencies, Hospice Care Providers, and Skilled Nursing Facilities.

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