SNF and SNF/PPS Compliance Services
Perform a prospective or retrospective review of a sample of SNF and SNF PPS claims and the corresponding medical record documentation to assure complete charge capture, accurate coding and documentary support for claimed services. This includes a focus on both revenue optimization and compliance with PPS requirements to avoid overpayment
Review a sample of Completed MDS's and related documents to evaluate accurate completion, correct diagnosis coding, correct assignment of primary diagnoses and resulting appropriate categorical patient assignment.
MDS audit & completion service
Coding: per diem and "backlog" coding services available by AAPC certified coders
Our Coding Helpline to answer coding/billing questions is available with a 24 hour response time in most cases.
A "Shadow Review service
for Third Party Payer "Medical
Claim Reviews" is available as an add-on or stand alone engagement.
Claim Denial, Suspend and Reduction reviews to assess problem
areas and identify solutions as well as preparation of Re-submissions & Payer Appeal
Litigation Support in Administrative Hearings, Fraud/Abuse Actions & Settlement Negotiations
HIPAA compliance reviews
Stark Law compliance reviews
Compliance Plans; implementation & training; focus is on the OIG's Model Compliance Plan for SNF's
Seminars on MDS Completion and medical record documentation for clinicians; includes focus on revenue optimization and prevention of overpayment through correct MDS completion and source document support; resulting in accurate patient categorical assignment
Seminars for para-professional staff on documentation requirements for source documents
"Update Seminars" are available; focusing on regulatory change
Billing seminars for SNF & SNF PPS services
All seminars are available on videotape
Additional services available