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When the media headlines included “aphasia” and Bruce Willis’ name, more and more people were learning what aphasia was: an acquired language disorder, affecting ability to express and/or understand language following neurological damage. Later, we learned that Bruce Willis was actually diagnosed with dementia and a part of that was the component of the language loss.

As healthcare providers, we can take a proactive approach to treating and caring for this patient population with these two different, but sometime overlapping diagnosis. Here are some general communication tips for caregivers to use with patients who may have either (or both) diagnosis:

  • Gain attention before communicating
  • Keep communication simple
  • Reduce rate of speech
  • Use visuals such as drawings, gestures, facial expressions
  • Give the person time to respond
  • Avoid “finishing” their sentences
  • Decrease background noise
  • Provide choices
  • Ask what they need help with
  • Maintain eye contact
  • Get to their level (sit if in wheelchair)
  • Never argue
  • Encourage and use nonverbal communication: gestures/pointing
  • Smiles can go a long way!

If your team would benefit from additional training or resources on how to communicate effectively and/or work with patients with Alzheimer’s Disease or Aphasia, please reach out to your RVP or Therapy Program Manager.

Each SNF to Receive 5-Claim Probe and Educate Review

In efforts to lower the SNF overpayment rate, CMS directed the Medicare Administrative Contractors (MACs) to perform a review of 5 claims for every SNF in their jurisdiction.

The claims sampled will be selected for pre-payment review, unless the provider requests post-pay reviews due to financial burden. If improper payments are identified following the review of the requested medical records, the MACs will adjust the claim payment and offer individualized education to the facility based on errors identified.

Reviews will be implemented starting June 5, 2023 on a rolling basis, starting with the top 20% of providers that show the highest risk, based on MAC data analysis.

It’s important to note that with these probes, MACs will no longer include the option within the notice letter that additional time can be requested; they will all be due within 45 days.

Upon receipt of the probe notice, all Encore customers should notify their designated Appeals Management Specialist (AMS) who will assist during the process.

A copy of the CMS Transmittal can be found at: Transmittal 12037.

If you have any questions regarding your AMS or this process, please reach out to

Telehealth Details from CMS

For SNFs and inpatient rehabilitation facilities (IRFs), under Part A, CMS pays through a bundled payment for all covered Part A services. To the extent that therapy services furnished via telehealth or telecommunications technology are covered Part A services, then these services would be considered part of the bundled prospective payment system under Part A and such services would not be separately billable for those patients in a Part A-covered SNF or IRF stay.

Part B outpatient therapy, DSMT, and MNT services furnished remotely by institutional providers of therapy should continue to be furnished and billed the same way they have been during the PHE, which can include the use of telecommunications technology.

CMS’ Updated FAQ on Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency

The topic of Telehealth is addressed on pages 9-10, item # 22 on the document which can be found here: CMS FAQ

Note: Encore has a Telehealth process for therapy services where our clinicians are trained on proper telehealth platform, billing codes, patient consent, and documentation requirements.

-Encore Rehabilitation’s monthly publication, designed to give you updates on trends we are seeing in the Post-Acute Care industry.-

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