Hospice Compliance, Home Health Compliance, OASIS Compliance & Home Health/Hospice Revenue Optimization Services
Perform a prospective or retrospective review of a sample of home health and/or hospice 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 overpayment prevention, including the very high risk area of ESRD patient population
OASIS completion services
Review a sample of Completed OASIS Documents to evaluate accurate completion, correct Diagnosis Coding, correct assignment of Primary Diagnoses and resulting appropriate categorical patient assignment
Coding: “per diem” and “backlog” coding services are available by AAPC certified coders
Our Coding Helpline to answer coding/billing questions is available with a 24 hour response 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 identify problem areas and their resolution as well as preparation of Re-submissions & Payer Appeals
Litigation Support in Medicare fraud/abuse actions
HIPAA compliance reviews, implementation & training
Stark Law compliance reviews
Compliance Plans, implementation & training; focus is on the OIG’s “Model Compliance Plan” for HHA’s
Seminars on OASIS completion and medical record documentation for clinicians; includes focus on revenue optimization and prevention of overpayment through correct OASIS completion and source document support resulting in accurate patient categorical assignment
Seminars for para-professional staff on documentation requirements for source documents
Billing seminars for HH and Hospice services
Update Seminars are available; focusing on regulatory change
All seminars are available on videotape
Additional Hospice Review
All of the above services are available to Hospice clients
Perform, as part of the claim review, an audit to assure Appropriate Intermediary and Carrier Billing of services; audit to assure palliative service billing only, documentary support for palliative services, maximal revenue optimization through correct modifier utilization and allowable Medicare Part B billings for attending physicians where applicable.
Compliance Plans, implementation & training; focus is on the OIG’s Model Compliance Plan for hospices
Additional services available