ABOUT HARMONY
Roger M.
Sarasota, FL
TN
The Harmony audit process is an intensive detailed review of the medical record content for potential revenue opportunities, medical record accuracy and compliance concerns.
 |
|
 |
1.Site visit preparation:
Before Harmony arrives at the facility we spend time collecting data to make our visit efficient and effective. Getting a head start in this process allows our healthcare experts to find the most financial opportunities during our on-site visit.
Medicare Part A RUGs Analysis: Harmony corporate office staff prepares a detailed analysis focused on the key elements for managing the Rehab RUGs III groups. Based on monthly Medicare Part A days and scores provided to Harmony by the facility, our tool breaks down each component contributing to eliciting a more robust RUGs III level as well as MDS 3.0 and RUG's IV implimentation and training.This analysis is utilized by our healthcare experts to enhance the Medicare team's approach to increase the Medicare Part A rate and revenue.
- Audit Agenda: Each facility audit consists of several components which are designed to expedite the process of Medicare Part A program enhancement. The Harmony Healthcare expert will orient the facility staff to the agenda for the site visit and answer any pressing questions to ease the facility staff during this process.
- Pre-visit Interview (data collection): Facility specifics regarding payor source census, competition, and type of Rehab services will facilitate efficiency during our initial site visit.
- Facility Contacts: Prior to the initial Harmony consulting site visit, we prepare for our visit by asking the facility to select point staff for our consultants to connect with during site visits.
- Analysis: Our healthcare experts review the collected data and formulate relevant areas of focus.
2.Site Visit:
|
7:45am - 8:00am
Arrival at the facility: Connect with key staff members, walk physical plant, establish auditing location
8:00am - 8:30am
Follow-up: The first order of business for subsequent visits is the follow-up of the facility’s completion of the prior visit recommendations. The follow-up process entails review of facility implementation and completion of Harmony’s last visit recommendations.
8:30am - 3:00pm
Audit: The core business of Harmony Consulting services is the chart audit. Comprehensive medical record review includes audit of current Medicare Part A patients. This process enables the consultant to identify areas of opportunity in:
- ARD Management
- Rehab Case Management
- Medicare Coverage Criteria
- ADL Coding
- Respiratory Therapy
- Nursing Documentation
- Therapy Documentation
Analysis: During the visit, the consultant collects facility-generated Medicare reports to fax to the Harmony Healthcare corporate office. The corporate office completes a comprehensive and detailed analysis which is returned to the consultant by the end of the site visit for discussion purposes. Areas include:
- Length of Stay Analysis
- Medicare Part A RUGs Analysis
- Medicare Part A Revenue Analysis
- Medicare Part B Revenue Analysis
- Therapy Staff Productivity
Training: Education and Training is an added service that occurs within the site visit. In-services to the facility staff include:
- ADL Coding
- Nursing Documentation
- Therapy Documentation
- MDS 101
- RUGs Revolution
- And a variety of other topics
3:00pm - 5:00pm
Exit Conference: At the end of each visit, an exit conference is performed with the Administrator, MDS Coordinator, Director of Nursing, Rehab Director and Therapy Staff. (Referred to as the Medicare Team). The facility may opt to invite other team members; i.e., Business Office Manager and Nurse Unit Managers, Admissions, Social Service and Discharge Planners.
3.Report Generation:
Our Audit Process far exceeds any other you will experience as our healthcare experts have the tenacity and persistence to perform in-depth, patient-specific medical record audits. We go to great lengths for our clients by spending extensive periods of time extracting the patient-specific detail. The result of this detail oriented medical record review is a customized facility report which is a resource for staff to conquer the constant challenge of enhancing patient care. Harmony believes that the foundation to increasing revenue is teaching staff to understand the core coverage components which in turn builds a great healthcare team. Our clients benefit from the Harmony in house support staff who prepares a multitude of behind the scenes reports during and between facility site visits.
Report Contents:
- Facility Census
- Facility Demographics
- Revenue Opportunities
- Case Management Reviews (Patient Specific Case Studies)
- Clinically Anticipated Length of Stay Analysis
- Therapy Staffing Analysis
- RUGs Analysis
- Site Visit Follow-up
- Executive Summary
4.Total Access:
- Our President communicates directly with each client and provides the administrator and owner with a personal e-mail containing a site visit synopsis with site visit highlights.
- Our Director of Education and Training is available to facility staff for unlimited access to answer questions, provide between visit consultations and interpret coverage criteria regulations.
- Our Corporate staff and healthcare experts are accessible to facility staff between site visits for questions regarding coverage criteria and Medicare Part A and B program management.
- Weekly Newsletter Archives: Harmony publishes weekly articles that address many issues and barriers to successful programming in the SNF. Past issues have tackled compliance, Denials and Appeals in addition to Documentionat Tips and Strategies.
- Harmony Manuals: Our annual contracts have access to the following Harmony manuals:
I. Medicare Manual: The Centers for Medicare and Medicaid has an intricate and dynamic system of reimbursement for Medicare Part A and Medicare Part B claims for the skilled nursing facility. Harmony has devised a Medicare Manual based on CMS guidelines for reimbursement. Included in this manual are samples and examples of skilled nursing documentation, skilled therapy documentation, Medicare Meeting policy and procedure, Respiratory Therapy forms, Diagnosis driven nursing documentation worksheets and simplified explanations of the complex reimbursement rules and regulations set by CMS.
II. Rehabilitation Manual: Harmony has devised a Rehabilitation Manual which is a resource for structuring a successful Therapy program under Medicare Part A and Medicare Part B reimbursement system. Included in this manual are sample augmentative evaluations (Restraint reduction, positioning, feeding, swallowing, falls, contracture), therapy evaluations, weekly progress notes, monthly progress notes, tracking and billing forms, efficiency and productivity tools.
