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Clinical Reimbursement
- Medicare A, B, Managed Care and Alternative Payment Models
- Utilization Review: RUGS, ADL’s, Length of Stay, Supportive Documentation
- Triple Check System: MDS / UB-04 Accuracy
- ICD-10-CM
- Rehab Utilization
- Benchmarking
- Consolidated Billing
- CMI
- Cost vs. Revenue Analysis
Education and Training
- Seminars on Medicare, MDS 3.0 and Regulatory Updates
- Five Star Rating
- Quality Measures
- MDS Coordinator Training and Mentoring
- DON and Nurse Management Training
- MDS Coding and Care Planning
Claims and Appeals
- Reviews: ADR, CERTS, PERMS, RACS, ZPICS, OMIG
- All Levels of Appeals
- Auditing to Identify Areas of Exposure
- Benefits Integrity Audits
Federal and Regulatory Compliance
- Conditions of Participation for Skilled Nursing Facility (SNF)
- Comprehensive Mock Surveys
- Plans of Correction
- IDR’s, I-IDR’s
- ALJ Hearing for CMP’s
- Facility Policies and Procedures
- Corporate Compliance
- Clinical Systems
- QAPI
- Customized Forms and Tracking Tools
