What we do
We provide a partnership that is focused on expanding your company’s growth.
Clinical Reimbursement Services
Service Package A:
MDS Data Entry Assistance Workflow
Our staff will assist your facility on data collection and entry of MDS information timely and accurately based on the information documented in the medical records and in accordance with company policy and procedures.
A. MDS Assessment Scheduling
B. Medical Records Comprehensive Review
C. MDS Data Collection & Entry
D. Diagnosis & ICD-10 Coding
E. MDS Export & Submission
F. MDS Acceptance Validation
Service Package B:
PDPM Opportunities/Compliance Review Workflow
Our staff will provide a thorough review of PDPM opportunities after mds completion and offer recommendations to ensure that your facility will be appropriately reimbursed for the services provided while ensuring compliance with federal and state guidelines.
A. HIPPS Code Verification & Missed Opportunity Alert
B. Supporting Documentation Compliance Alert – GG, BIMS,
PHQ9, Diagnosis & ICD-10 Coding
C. Change in Condition & IPA Identification
D. CMI and Financial Impact Projection
E. Physician Certs/Recerts Compliance Review
F. NOMNC/SNFABN Compliance Review
G. Skilled Services Documentation Review & Recommendation
ABN – ADVANCE BENEFICIARY NOTICE (OF NON-COVERAGE)
BIMS – BRIEF INTERVIEW FOR MENTAL STATUS
CMI – CASE MIX INDEX
HIPPS – HEALTH INSURANCE PROSPECTIVE PAYMENT SYSTEM
ICD – INTERNATIONAL CLASSIFICATION OF DISEASES
IPA – INTERIM PAYMENT ASSESSMENT
MDS – MINIMUM DATA SET
NOMNC – NOTICE OF MEDICARE NON-COVERAGE
PDPM – PATIENT-DRIVEN PAYMENT MODEL
PHQ – PATIENT HEALTH QUESTIONNAIRE
SNF – SKILLED NURSING FACILITY