Author: Sandy McCleve

Sandy McCleve is the Principal 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.

Be Ready To Pounce On Institutional Billing Details

By Sandy McCleve
November 28, 2018
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Pointer: Start checking HETS reports for hospital billing ASAP. Not only does the new case mix factor on institutional versus community admission source complicate reimbursement levels, it also complicates the billing … Continue Reading →

Medicare Includes Hospice In Its Regulatory Relief Proposals

By Sandy McCleve
November 16, 2018
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Proposal aims to eliminate requirements related to aides, medication management, and facility staff training. While any lightening of hospices’ regulatory load is good news, Medicare’s latest plan to cut red tape … Continue Reading →

Medicare Cost Report: What is it?

By Sandy McCleve
November 15, 2018
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All Medicare certified institutional providers are required file an annual cost report to their respective Medicare Administrative Contract (“MAC”). But what is a Medicare cost report and what is the … Continue Reading →

Regulations: Ready Or Not, 30-Day Billing Periods Are On The Way

By Sandy McCleve
November 15, 2018
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Medicare officials claim switch won’t increase burden. It’s no surprise that the Patient-Driven Groupings Model will implement 30-day billing periods, since the change was required by law this year. But that won’t make … Continue Reading →

Billing: PPS Rule Finalizes First Step Of RAP Elimination

By Sandy McCleve
November 14, 2018
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New HHAs no longer will receive RAP payments under PDGM. Despite many strident industry comments opposing the elimination of Requests for Anticipated Payments, Medicare has started down that path anyway. … Continue Reading →

Reimbursement: CMS Hangs Onto Behavioral Assumption Adjustment Cuts, Despite Industry Outcry

By Sandy McCleve
November 13, 2018
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Industry needs Congress’ help. While the Patient-Driven Groupings Model is supposed to be a budget-neutral reform to how Medicare pays home health agencies, in realityproviders will see a big cut in transitioning … Continue Reading →

2019 Rate Increase Largest In More Than A Decade

By Sandy McCleve
November 12, 2018
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Plus: Outlier formula tweak will make them a little easier to obtain. Not surprisingly, home health agencies are consumed with the details of the payment reform model included in the … Continue Reading →

Hospice Cap Season Begins

By Sandy McCleve
November 7, 2018
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With the 2018 hospice cap reporting year ended as of Sept. 30, now’s the time for hospice providers to deal with the consequences. Item #1: Hospices must report their cap level and … Continue Reading →

HH PPS Final Rule With PDGM Payment Reform Is Out

By Sandy McCleve
November 7, 2018
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Retained behavioral adjustment provision ruins new model, trade group insists. Medicare issued its Home Health Prospective Payment System final rule on Halloween, and it contains some provisions scarier than any … Continue Reading →

Find Out Changes Medicare Made To MCReF System Based On User Feedback

By Sandy McCleve
October 19, 2018
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Learn how to use the new Medicare Cost Report e-Filing (MCReF) system. The session will offer a detailed overview as well as changes made based on user feedback, the Centers for Medicare … Continue Reading →