Services


SNF/LTC

  • PDPM process review and implementation of advanced processes for optimal outcome

  • Managed Care process review and implementation of advanced processes

  • Managed Care contract review and rate negotiation for contract renewal and timely recredentialing

  • Weekly, Bi-weekly, monthly, and quarterly compliance audits

  • Additional Documentation Review (ADR)  and appeals by CMS, their contracted auditors, and Managed Care companies with no recoupment 

  • Quality Measure star review, implementing processes to assist with increasing QM Star to 5 Star, contributing 1 Star to the overall Star rating

  • Centralizing PDPM and Managed Care processes by implementing in-house best practices and monitoring for optimal outcomes

New York Medicaid CMI Case MIX

  • Universal Assessment System (UAS) assessment process review and implementation of best solutions for optimal outcome

  • Ad Hoc Report in Health Commerce System for easy access and review of UAS assessments 

  • Revenue reports to track weekly and monthly revenue and PPD in real-time 

  • Partnership with Rehabilitation companies for Medicare Part A and Part B services

  • Weekly utilization review meeting to monitor and capture rehab services and nursing skilled services to maximize revenue