Without consistent MDS management, TLC Management was feeling pinched.
The health care consultant operating across Indiana and Florida found itself unable to maintain the oversight and Minimum Data Set (MDS) management necessary to drive the assessment process and optimize reimbursement opportunities. For skilled nursing operators, meticulous MDS management and optimal reimbursement strategies hold paramount importance.
These factors not only influence financial stability but also play a pivotal role in maintaining a high standard of patient care.
“Losing an MDS coordinator means losing money,” says Leslie Piper, TLC’s Director of Clinical Reimbursement.
In June 2022, with a vision to streamline operations and bolster their financial bottom line, TLC Management embarked on a partnership with MedaSync. The collaboration aimed to address critical challenges in staffing, time management, oversight, and reimbursement accuracy.
TLC Management’s key challenges
For Piper and the team at TLC Management, sustaining necessary oversight and management levels in the absence of an MDS coordinator presented a myriad of difficulties. MDS coordinators bear a spectrum of responsibilities spanning admissions, care planning, utilization reviews and regular meetings, and the manual nature of these tasks impedes swift operations, leading to missed reimbursement opportunities.
Time management is crucial for these coordinators, and an organization working without one faces an uphill battle for ensuring accurate reimbursement. TLC Management’s reliance on manual methods was hindered by its limited resources, exacerbating challenges during periods of staffing scarcity.
The intricate interplay of staffing, oversight and time management had a direct impact on the organization’s reimbursement potential. Even minor oversights resulted in substantial revenue loss, underscoring the significance of these components for the organization’s overall financial well-being.
Revolutionizing with MedaSync — for wins in both Medicare and Medicaid
The transformative solution for TLC Management came from MedaSync, an AI-powered reimbursement software.
To start, TLC rolled out MedaSync in six of its Indiana facilities as a 90-day trial, and the choice to expand was easy as MedaSync’s value was reflected throughout operations.
“The ROI spoke for itself in the Medicaid rate alone,” Piper says.
The TLC team also saw positive impacts on the Medicare rate as well. Strictly driven from a reimbursement standpoint, MedaSync became a powerful asset for improving TLC’s bottom line, and after only three months, TLC Management expanded it to all 15 of its Indiana facilities.
By seamlessly integrating with TLC Management’s EHR, MedaSync provided Piper and the team real-time monitoring of patient data. This automated analysis generated concise patient summaries and proactive alerts, pinpointing crucial patient documentation and changes essential for reimbursement. The benefits were swift:
- No manual errors
- Accurate reimbursement reflective of the care provided
- Employees save several hours a week and can be more intentional with their time
Diverging from conventional methods, MedaSync emulates manual chart reviews to identify real-time patient changes even before assessments are initiated. This adaptability extends beyond Medicaid CMI, accommodating Managed Care and Medicare regulations, thus catering to the diverse needs of all SNFs.
Tangible results achieved: increased daily reimbursement, happier staff
As Piper notes, TLC Management’s collaboration with MedaSync bore fruit in a short span.
TLC witnessed an average increase of $25 per day per Medicaid resident within two months, a 0.25 increase in CMI across their trial-run buildings in Indiana. This was driven by enhanced accuracy and efficiency in capturing the intricacies of patient care, benefiting both reimbursement capture and MDS management.
The software’s adaptability, ease of integration and personalized engagement stood out to Piper during the exploration phase. TLC employees who were initially skeptical of the need for the software experienced a swift change of heart as MedaSync streamlined workflows, transformed time management and elevated oversight capabilities.
“MedaSync works with us to make the program work for us,” Piper says.
TLC Management pays it forward with MedaSync
Encouraged by initial success, TLC Management expanded MedaSync’s implementation across all 15 Indiana facilities. This step significantly influenced both Medicaid and Medicare rates, underscoring MedaSync’s power in capturing patient care complexities and boosting reimbursement efforts.
Piper and the organization had one more key outcome: they now tell everyone about just what kind of a difference MedaSync made for them.
“You feel like a family, like you’re the only client they’re taking care of,” Piper says. “You can reach out and your request doesn’t sit on the back burner.”
This article is sponsored by MedaSync and is based on a new case study. To learn more, click here to download the free, full case study.
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