MDS responsibility @Triple Check

Specialties MDS

Published

What is MDS responsibility @ a Triple Check meeting?

Specializes in Gerontology, Med surg, Home Health.

What is a triple check meeting?

Meeting with Billing, MDS, & Rehab Dept. Not sure what my role as MDS is yet. I think there is a billing form UB90? that we check RUG levels & Certs.

I have never heard of a triple check meeting but we (meaning me (MDS nurse) and the business office and rehab) check all the billing for the month prior to and make sure each one has the right amount of days skilled, RUG level billed at, and making sure the MDS was submitted and accepted before billing can occur.

Specializes in LTC, Hospice, Case Management.

Ah Ha... you must be a Life Care employee! (I know this because I am one too). Where are you at?

When I go to triple check I always go with an assessment summary. BOM heads the mtg - she reads off res name, MCR # and all the rest of the heading stuff. I verify that RUGS/HIPPs scores are correct, paying the correct amount days, pharmacy & lab charges are accurate and appropriate. Therapy & I verify ICD-9 codes are appropriate and therapy verifies their charges are appropriate.

I look for things like rehab RUGS without therapy charges on the bill (which could be a problem but not always.. like if therapy actually ended the very end of previous month and RUG score didn't get changed with OMRA til into the current month). I look for pharmacy charges that don't make sense. In my facility, therapy initiates the ICD-9 scores for billing, but I don't always agree with them so that sometimes turns into a lively debate (esp. when they start using 800 codes for fractures - grrr).

Currently I am the ADON, but after 10years of MDS my facility has mandated that I stay in triple check as I catch things the others don't see. We also have medical records in the meeting and she brings the weekly validation book. Thankfully, I don't have to attend weekly validation meeting too!

Fun meeting (sarcasm). Bring chocolate - it gets me through it most months.

Specializes in Assessment coordinator.

Kindred has hellacious triple check meetings too! I work for an Avalon facility now, and triple check is easy because we all do our jobs right. I don't have to verify the pharmacy charges, but other than that it's the same as you describe. My bldg has about 30 Med A's at any given time, so triple check is about an hour.....avg 2 min/pt.

ST

I am trying to set up a formal Triple Check meeting at a facility I am helping at. Does any one have a Triple Check Meeting format? A checkoff list for example?

I would be so thankful for any help here.

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