We have had other consulting companies come and make big promises to increase our revenue. The other companies failed and pale in comparison to Harmony. Harmony provides us with such a detailed report that each department can clearly identify strategies for improvement. This is the first company that has provided input for our therapy staff on treatment ideas.Beverly S.
Nashville, TN

Medicare and Medicaid Reimbursement Consulting

The objective of Harmony's Medicare and Case Mix Reimbursement Audit site visit is to review the medical records for information that supports the services documented on the MDS as they relate to RUG-III and RUG-IV reimbursement. In addition this process reviews for compliance with rules and regulations using a retrospective sample. Historically this process has resulted in significant revenue increases ranging from $10k - $300k per month.

Site Visits include:

  • Medicaid Casemix Audits i.e. MMQ, Tile, PRI
  • Medicare Part A Coverage
  • PPS MDS Assessments
  • MDS 3.0 Training

Case Study: ADL Coding

Client: This client is a SNF associated with a hospital and located in Maine with 77 certified beds and an ADC of 15 – 20 Medicare Part A patients per day began with a Medicare Part A rate of $302.00.

Issues: Percentage of “X” days was approximately 17%, with total Medicare Part A revenue reported at $162,000,000. CNA, nursing staff and therapies did not understand the MDS language for ADL coding in section G.

Harmony Approach: The Harmony site visits focused on training the facility staff and staff development coordinator in ADL coding while facilitating understanding of nursing and therapy language for scoring patient performance. Harmony assisted the facility MDSC in identifying areas to seek clarity for accuracy in coding the MDS.

Outcomes as of 2008:

  • Average Daily Census: 21
  • Medicare Part A Revenue: $225,000.00
  • X Days % of Total: 20 – 25%
  • Medicare Part A rate: $344.00 (Increase of $42.00 per day)

FREE RUGS ANALYSIS