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