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Regulatory Protocols: Clinical Compliance Oversight

Clinical compliance - ensure therapy complianceTherapy Consulting - Clinical Compliance

Our clinicians work with your therapists to improve their clinical skills.  Our goal is to maximize the therapeutic outcomes achieved for your patients.  Our facility profile sets a "baseline" to determine the appropriate and expected therapeutic interventions.  eRehabDirect’s service plan is designed to maintain quality measures and ensure compliance management.

Therapists practice in a difficult regulatory environment with State Surveys, Case Mix reviews, PPS, RUG's IV, MDS 3.0, the Correcting Coding Initiative, 8 Minute Rule, and the Medicare Part B Exceptions Process.  Our clinicians have the compliance expertise and technical support to manage patient care in this difficult environment. 

 

Our Premier Virtual eRehabDirect Service Will......

Prevent Med A Revenue Reductions & Med B Claims Denials

  • Oversee treatment plans and ARD selections to minimize COT OMRA’s.
  • Plan optimum levels of treatment minutes by mode while ensuring compliance.
  • Verify that concurrent and group sessions comply with applicable regulations.
  • Monitor the assignment of modifiers to prevent denials.
  • Minimize the MPPR fee adjustment to Medicare Part B claims.
  • Alerts your staff about missing documents, deadlines, and compliance errors.
  • Ensure documents support the medical necessity of charges billed.

Our Clinicians Have the Skills to Ensure Therapy Compliance

  • Manage OMRA’s, Short Stay Assessments, and Midnight rules.
  • Plan treatments to prevent COT, EOT, and EOT-R OMRA’s.
  • Review compliance with CCI Edits and the 8 Minute Rule.
  • Guide staff in CPT code selection to manage conflict codes.
  • Manage Med B visits remaining, exceptions, and referral opportunities.
  • Implement strategies to reduce MPPR fee adjustments.
  • Perform chart reviews to improve document quality and prevent denials.

 

Ongoing clinical compliance oversight as part of a daily routine identifies and corrects clinical issues before they become compliance audit problems.  Our proven software and oversight procedures ensure that charges and supporting documents “stand up” to medical review, comply fully with HIPAA regulations, and protect the health records of your patients.