How MDS 3.0 Works:
This intelligent AI agent analyzes your patient data, identifies potential coding discrepancies, and provides clear, actionable suggestions to ensure you receive appropriate reimbursement for the care you provide. Ultimately, this leads to improved patient outcomes and a significant reduction in administrative paperwork. MDS 3.0 acts as a continuous clinical documentation review tool. It scans every single clinical note, medication and assessment against the current MDS record for each of your managed care patients in the Patient Driven Payment Model (PDPM). The AI identifies patients where clinical notes suggest potential changes to the existing MDS coding, ensuring accurate reflection of the patient's condition and care needs.
Navigating the MDS 3.0 Dashboard:
The MDS 3.0 dashboard offers a comprehensive view of potential coding improvements. You can customize your view based on your preference:
Display Options: View potential reimbursement changes by Case Mix Index (CMI), Case Mix Group (CMG), or dollar amount.
In progress, Completed, Discharged: You can easily switch between MDS submissions that are in draft status and completed MDS by using the tabs at the top of the page. You can use the Discharged tab to see recently discharged patients and suggestions. The suggestions will compare what is currently entered in the draft MDS or completed MDS against all notes, diagnosis codes, and current and historical orders.
Filtering: By default, the dashboard displays all patients with AI-suggested reimbursement opportunities. However, you can update filters and easily sort results to support your workflow.
Facility: The facility filter is a multi-select filter that allows you to view MDS opportunities for specific facilities.
ARD: Filter MDS patients by the Assessment Reference Date to focus on assessments due within a specific date range.
Type: Refers to the type of AI evidence. This is a multi-select filter. "Suggestion" indicates AI evidence with high confidence. "Needs Review" indicates AI evidence where human review is recommended. "Active in MDS" will show the MDS coding details that have already been coded in the patients MDS. "Inactive" will show all of the MDS selections that have not yet been coded in the patients MDS.
Revenue Impact: By default the results are filtered to only show patients where AI evidence supports additional reimbursement opportunities. Updating this filter to "All Findings" will show all MDS, including those with no AI findings.
Additional filters: You can also filter for patients that have not yet been reviewed, search by patient, MDS form description, and eligibility date.
Customization: The gear icon in the top right corner allows you to customize the displayed columns and their order. You can also sort the list by rate change, patient name, or any of the MDS categories.
Sorting: Sort by "Rate Change" or any other column to prioritize patients with the highest potential reimbursement increase in that particular category.
Search: The global search function allows you to quickly find specific patients or facilities.
Understanding the Data:
The MDS 3.0 application provides a detailed breakdown of suggested changes across all MDS areas. Select a patient and expand the suggestions to to see all evidence for the suggestion.
Suggested Changes: The dashboard highlights every patient with suggested changes and the specific MDS categories impacted.
Detailed Recommendations: Expanding a patient's record reveals the precise recommended changes within each MDS category.
Evidence-Based Insights: Each recommendation is accompanied by clear, concise explanations and supporting evidence.
Highlighted Clinical Notes: The application displays the relevant clinical notes, highlighting the specific portions that support the suggested changes.
Asterisk: An AI suggestion with an * indicates that further validation by you may be needed. Some items may require a combination of criteria. While AI can suggest evidence for partial criteria, additional evidence or user validation or observations may be needed for the remaining criteria.
Interacting with the AI Agent:
Thumbs Up: Use the thumbs up tool to approve suggested MDS changes. This will help you efficiently make MDS changes once you've reviewed opportunities.
Thumbs Down: By using the thumbs down option, you are indicating that the provided evidence was insufficient to justify the suggested change in the specific MDS category for the specific patient. When you reject the suggestion the AI agent will not make the suggestion for the specific patient again unless new evidence is found. The rate change will also adjust accordingly.
Key Benefits of MDS 3.0:
Increased Reimbursement: Ensure accurate coding and capture appropriate reimbursement for the care provided.
Improved Operational Efficiency: Reduce time spent on manual chart review and coding.
Enhanced Patient Outcomes: Accurate coding reflects the patient's needs, leading to more appropriate care planning.
Reduced Paperwork: Streamlined documentation and coding processes minimize administrative burden.
Troubleshooting:
Why don't I see all of my facilities? As MDS is currently configured for managed care PDPM only, only facilities with active managed care patients will be accessible in the application. If there are active Medicare patients in a given facility and you are not seeing that facility in the MDS 3.0 reach out to support@anthuria.ai.
Why don't I see all patients? As MDS is currently configured for managed care PDPM patients only, only patients currently under managed care PDPM will be accessible in the application. If there are active Medicare patients in a given facility and you are not seeing them in the MDS 3.0 reach out to support@anthuria.ai.
How does MDS 3.0 consider Section GG: Functional Abilities and Goals? The application includes suggestions specific to section GG. When you expand PT/OT suggestions you will see all GG evidence highlighted. Due to the subjective nature of GG assessments and regional variation we aren't yet providing rate changes. Rate change analysis for this category is coming soon.