Services that bring the pieces of the compliance puzzle together. 

In order to ensure compliance, you know we need an assessment of the risks, education to negate the risks, and then follow up to ensure we met those goals. 

 

Provider Insights, Inc. can provide any of these services, to support your compliance, or all three if you need the complete picture. 

Operational and Compliance Assessments

 

An assessment with a 360 degree view - from intake to billing - we will look to ensure your processes not only support compliance, but they are effiecient and support best practices. Assessment can be tailored for your agency needs, and include Mock Surveys, productivity/effieciency assessments or overall Compliance/Risk assessments. Solutions and a plan are developed based on your individual agency's needs and goals. 

Educational Event Topics:

 

Home Health

- Case Management

- Medicare Eligibility

- Skilled Need and Medical Necessity

- Documentation

- Best Practices for Best Outcomes

- Advanced Beneficiary Notice (ABN) and Home Health Change in Care Notice (HHCCN)

- Clinician Documentation Impacting Payment

- Additional Development Request Process (ADR) and Appeals

 

Hospice

- Eligibility

- Documenting Visits

- Level of Care

- Documentation of Terminal Prognosis

- Local Coverage Determination (LCD's)

- Effective IDG Meetings

- Additional Development Requests Process (ADR) and Appeals

Audit Support

 

Whether you are being proactive and desire assistance with your quarterly medical record reviews, or if you are facing audits by CMS contractors, Provider Insights, Inc. can support you. With our experience working with CMS contractors, we can help guide you through the maze of mecial review and the appeals process, whether you are being reviewed by your MAC, RAC, or ZPIC. We provide record review and preparation as well as clinical summaries to serve as a "roadmap" for the reviewers.