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The Patient-Drive Payment Model (PDPM) is here, and AANAC will continue to help you through the transition. Visit this page frequently for new tools, education, and resources for ongoing success under PDPM.
From January 26 through February 16, 2020, a software issue caused Skilled Nursing Facility (SNF) claims to be incorrectly cancelled with a message that there was no three day qualifying hospital stay. This issue is corrected. If your claims were incorrectly cancelled, re-bill them in sequential order to receive payment.
· Claims need to process in date of service order for each stay for the Variable Per Diem (VPD) to calculate correctly
· Submit claims in sequence and wait at least 2 weeks before billing subsequent claims
· Some of the affected claims with older dates of service will require a timely filing exception; enter “Resubmission due to non-qualifying stay” in the remarks field
· This issue was not caused by the recent implementation of the SNF Patient Driven Payment Model
· Contact your MAC to receive the Medicare Beneficiary Identifier (MBI) for deceased beneficiaries